Treatments for Eating Disorder not Otherwise Specified (ENDOS)
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Anorexia:
Treatment
(In A Page: Pediatric Signs and Symptoms)
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Treatment geared toward specific causes
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Maintain hydration status and correct any electrolyte and vitamin imbalances
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Treat infectious causes if indicated
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Counseling for psychiatric causes
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May require NG feeds to maintain nutrition
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Remove toxic agents
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Lower esophageal dilation or myomectomy for achalasia
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Parental education regarding expectations
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Treat depression
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Polyphagia:
Treatment
(In A Page: Pediatric Signs and Symptoms)
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Insulin therapy for diabetes mellitus
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Graves disease is treated with antithyroid medication, thyroid radioablation, or surgical thyroidectomy
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Stop offending medications or substances if possible
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Psychiatric conditions require treatment directed at the specific cause
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Lesions of the hypothalamus require treatment directed to the specific cause
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Syndromes such as Prader-Willi and Laurence-MoonBardet-Biedl require multidisciplinary treatment from endocrinology, nutrition, and other subspecialities
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Diabetes insipidus
–Free water replacement while on formula
–DDAVP when older
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Anorexia nervosa:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Appropriate treatment aims to promote weight gain or control the patient’s compulsive binge eating and purging. Malnutrition and the underlying psychological dysfunction must be corrected. Hospitalization in a medical or psychiatric unit may be required to improve the patient’s precarious physical condition. The hospital stay may be as brief as 2 weeks or may stretch from a few months to 2 years or longer.
A team approach to care — combining aggressive medical management, nutritional counseling, and individual, group, or family psychotherapy or behavior modification therapy — is most effective in treating anorexia. Treatment results may be discouraging. Many clinical centers are now developing inpatient and outpatient programs specifically aimed at managing eating disorders.
Treatment may include behavior modification (privileges depend on weight gain); curtailed activity for physical reasons (such as arrhythmias); vitamin and mineral supplements; a reasonable diet with or without liquid supplements; subclavian, peripheral, or enteral hyperalimentation (enteral and peripheral routes carry less risk of infection); and group, family, or individual psychotherapy.
All forms of psychotherapy, from psychoanalysis to hypnotherapy, have been used in treating anorexia nervosa, with varying success. To be successful, psychotherapy should address the underlying problems of low self-esteem, guilt, anxiety, feelings of hopelessness and helplessness, and depression.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Anorexia nervosa:
Treatment
(Handbook of Diseases)
Appropriate treatment aims to promote weight gain or control the patient’s compulsive binge eating and purging and to correct malnutrition and the underlying psychological dysfunction. Hospitalization in a medical or psychiatric unit may be required to improve the patient’s precarious physical condition. The facility stay may be as brief as 2 weeks or may stretch from a few months to 2 years or longer.
team approach
The most effective treatment for anorexia combines aggressive medical management, nutritional counseling, and individual, group, or family psychotherapy or behavior modification therapy. Treatment results may be discouraging. Many clinical centers are now developing inpatient and outpatient programs specifically aimed at managing eating disorders.
Treatment may include behavior modification (privileges depend on weight gain); curtailed activity for physical reasons (such as arrhythmias); vitamin and mineral supplements; a reasonable diet with or without liquid supplements; subclavian, peripheral, or enteral hyperalimentation (enteral and peripheral routes carry less risk of infection); and individual, group, or family psychotherapy.
All forms of psychotherapy, from psychoanalysis to hypnotherapy, have been used in treating anorexia nervosa, with varying success. To be successful, psychotherapy should address the underlying problems of low self-esteem, guilt, anxiety, feelings of hopelessness and helplessness, and depression.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Anorexia:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the patient about his specific condition. Also teach him the importance of good nutrition. Encourage him to perform oral hygiene before meals. Review the patient’s target weight and instruct him to weigh himself and keep a weight log.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Polyphagia:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Offer the patient with polyphagia emotional support, and help him understand its underlying cause. As needed, refer the patient and his family for psychological counseling.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Anorexia:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Because the causes of anorexia are diverse, diagnostic procedures may include thyroid function studies, endoscopy, upper GI series, gallbladder series, barium enema, liver and kidney function tests, hormone assays, computed tomography scans, ultrasonography, blood studies to assess the patient's nutritional status and, possibly, a mental health evaluation.
▪ Promote protein and calorie intake by providing high-calorie snacks or frequent, small meals.
▪ Encourage the patient's family to supply his favorite foods to help stimulate his appetite.
▪ Because the patient may consistently exaggerate his food intake (common in the patient with anorexia nervosa), you'll need to maintain strict calorie and nutrient counts for the patient's meals.
▪ In severe malnutrition, provide supplemental nutritional support, such as TPN or oral nutritional supplements.
▪ Because anorexia and poor nutrition increase the patient's susceptibility to infection, monitor his vital signs and white blood cell count and closely observe any wounds.
Patient teaching
▪ Explain the patient's condition and treatment plan to him and his family.
▪ Stress the importance of proper nutrition.
▪ Instruct the patient to perform oral hygiene before meals.
▪ Teach the patient techniques to help manage the disorder, including establishing a target weight, recording his weight daily, and maintaining a record of his progress by keeping a weight log.
▪ Encourage the patient to seek psychological and nutritional counseling.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Polyphagia [Hyperphagia]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor the patient's eating habits and oral intake.
▪ Monitor the patient's daily weight.
▪ Provide emotional support.
▪ Obtain a mental health consult, if indicated.
Patient teaching
▪ Refer the patient to a registered dietitian or weight loss program for nutritional counseling, if appropriate.
▪ Explain the underlying disease process and its treatments.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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