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Psychological factors, such as perfectionism, body image distortion, and low self-esteem, are also strongly associated with anorexia nervosa. Individuals with anorexia may have unrealistic expectations about their body and a distorted perception of their weight. They may also experience anxiety, depression, and obsessive-compulsive behaviors.

Environmental factors, including cultural pressures to be thin, family dynamics, and societal expectations, can contribute to the development and maintenance of anorexia nervosa. Exposure to unrealistic body images in media and social media can further exacerbate body dissatisfaction and disordered eating behaviors.

Reference:

• National Eating Disorders Association (NEDA). (2023). Anorexia nervosa. [invalid URL removed]

Cultural, Financial, and Environmental Implications

Cultural Implications:

Cultural norms and values can play a significant role in the development and maintenance of anorexia nervosa. In cultures that emphasize thinness as a sign of beauty and success, individuals may feel pressure to conform to these unrealistic standards. This can lead to unhealthy eating behaviors and a distorted body image.

Financial Implications:

Anorexia nervosa can have a significant financial impact on individuals and their families. Treatment for anorexia can be expensive, requiring hospitalization, therapy, and medication. Additionally, the disorder can lead to lost productivity and income, as individuals may be unable to work or maintain their education.

Environmental Implications:

Environmental factors, such as exposure to media and social media, can contribute to the development of anorexia nervosa. Unrealistic body images and messages promoting thinness can create a toxic environment that reinforces negative body image and disordered eating behaviors.

Priority Nursing Interventions

1. Monitor vital signs: Closely monitor vital signs, including heart rate, blood pressure, and temperature, to assess for signs of dehydration, electrolyte imbalances, or cardiac arrhythmias.
2. Assess nutritional status: Evaluate the patient’s weight, body mass index (BMI), and dietary intake to assess the severity of malnutrition.
3. Correct fluid and electrolyte imbalances: Administer intravenous fluids and electrolytes as needed to address dehydration and electrolyte disturbances.
4. Provide nutritional support: Encourage or assist with eating, and consider the use of nasogastric tube feeding if necessary.
5. Address psychological factors: Provide psychological support, including cognitive-behavioral therapy (CBT) and family-based therapy, to address underlying issues related to body image, self-esteem, and disordered eating behaviors.

Labs and Diagnostic Testing

• Complete blood count (CBC): To assess for anemia, which is common in anorexia nervosa.
• Electrolyte panel: To evaluate electrolyte imbalances, such as hypokalemia and hyponatremia.
• Liver function tests: To assess liver function, which can be affected by malnutrition.
• Renal function tests: To evaluate kidney function, which can be compromised in cases of severe dehydration.
• EKG: To assess for cardiac arrhythmias, which can be a complication of anorexia nervosa.

Critical Indicators:

• Bradycardia: A heart rate below 60 beats per minute can be a sign of severe malnutrition and electrolyte imbalances.
• Hypotension: Low blood pressure can indicate dehydration or electrolyte imbalances.
• Hypothermia: Low body temperature can be a sign of malnutrition and decreased metabolic rate.
• Electrolyte imbalances: Low potassium (hypokalemia) and low sodium (hyponatremia) are common in anorexia nervosa and can lead to serious complications.

Reference:

• American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). American Psychiatric Association.

Interdisciplinary Team

A holistic approach to patient-centered care for individuals with anorexia nervosa requires the collaboration of a multidisciplinary team. This team may include:

• Psychiatrist: To diagnose and treat underlying psychiatric conditions, such as depression or anxiety.
• Registered dietitian: To provide nutritional guidance and support.
• Psychologist or therapist: To provide individual or family therapy to address psychological factors contributing to the disorder.
• Social worker: To assist with social support, family dynamics, and community resources.
• Physical therapist: To help with physical rehabilitation and improve functional abilities.