Treatments for Underweight
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Weight Loss:
Treatment
(In a Page: Signs and Symptoms)
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Identify and address the underlying cause
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Appetite disturbance of depression may be reversed by antidepressant medications
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Pancreatic enzymes for pancreatic malabsorption
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Referral to nutritionist if necessary
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Referral to social services if necessary
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Anorexia of malignancy and AIDS can be treated with megestrol acetate or dronabinol
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Aggressive treatment of anorexia nervosa, including evaluation for electrolyte and cardiac disorders and consultation with psychiatrist or psychologist
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Weight Gain:
Treatment
(In a Page: Signs and Symptoms)
-
Weight loss by low-calorie diet and exercise
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Discontinue or change offending medications if possible
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Treat underlying medical disorders
–CHF: Diuretics, digoxin, ACE inhibitor, nitrates, salt
restriction
–Liver disease: Diuretics, paracentesis, salt restriction
–Nephrotic syndrome: Diuretics, anticoagulation,
nephrology referral
–Cushing's disease: Surgery to remove tumor
–Cushing's syndrome: Search for and treat the underlying
cause (e.g., resection of tumor); diet
–Depression: Antidepressants, counseling
–Hypothyroidism: Thyroid hormone replacement
–Diabetes: Oral medications, insulin, diet, exercise
–Polycystic ovarian syndrome: Diet, oral contraceptives
–Pregnancy: Prenatal care
–Pre-eclampsia: Bedrest, magnesium sulfate,
antihypertensive meds, deliver baby if necessary
–Bulimia: Psychiatry referral
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Anorexia:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
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
-
Treat depression
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Weight Loss:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Initial goals are to achieve fluid balance via rehydration and to correct electrolyte disturbances
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Caloric assessment and possible dietary supplementation
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Treat infectious causes if medically indicated
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Psychiatric care
–For eating disorders, depression, drug abuse
-
Malabsorption
–May require special formulas/restriction diets
–May require pancreatic enzymes
-
Treat endocrine disturbance
-
Anti-inflammatory medications for IBD
-
Surgical correction of cardiac anomalies
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Diarrhea – Chronic, No Blood or Weight Loss:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treatment is directed at cause
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Chronic nonspecific diarrhea
–Restriction of fluid intake to <90 mL/kg/day
–Reduction of fruit juices (<8 ounces/day)
–Elimination of sorbitol-containing juices
-
Carbohydrate malabsorption
–Trial elimination or reduction of offending sugar
–Lactase (Lactaid) for lactose intolerance
–Sucrase (Sucraid) for sucrase-isomaltase deficiency
-
Small intestine bacterial overgrowth
–Antibiotic therapy with metronidazole alone or in combination with ampicillin or Bactrim
–Surgery for partial small bowel obstruction
-
Low-fat diet: Increase fat intake to approximately 40% of total daily calorie intake
-
Irritable bowel syndrome
–Anticholinergic therapy or antidepressants
-
Acrodermatitis enteropathica: Zinc supplements
>>>>> >>
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Diarrhea – Chronic, with Weight Loss:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Correct malnourished states
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IBD: Anti-inflammatories (e.g., steroids, 6MP, 5ASA)
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CD: Lifelong gluten-free diet
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CF: Pancreatic enzyme and nutritional supplements including fat-soluble vitamins (ADEK)
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Allergy: Food antigen avoidance
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Sucrase-isomaltase deficiency: “Sucraid” enzyme
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Neural crest tumors: Surgical resections
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VIPoma: Somatostatin
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Gastrinoma: Proton pump inhibitors
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Whipple disease: Trimethoprim-sulfamethoxazole
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Abetalipoprotenemia: No specific treatment
–Supplements of fat-soluble vitamins and MCT oil
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Acrodermatitis enteropathica: Zinc supplements
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Giardiasis: Metronidazole or nitazoxamide
-
Hyperalimentation: Parenteral nutrition may be needed for familial enteropathies
» 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
Weight gain, excessive:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Educating the patient about weight control is extremely important. Stress the benefits of behavior modification and dietary compliance. Help the patient plan an appropriate exercise routine.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Low birth weight:
Emergency Interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
Because low birth weight may be associated with poorly developed body systems, particularly the respiratory system, your priority is to monitor the neonate’s respiratory status. Be alert for signs of distress, such as apnea, grunting respirations, intercostal or xiphoid retractions, or a respiratory rate exceeding 60 breaths/minute after the first hour of life. If you detect any of these signs, prepare to provide respiratory support. Endotracheal intubation or supplemental oxygen with an oxygen hood may be needed.
Monitor the neonate’s axillary temperature. Decreased fat reserves may keep him from maintaining normal body temperature, and a drop below 97.8° F (36.5° C) exacerbates respiratory distress by increasing oxygen consumption. To maintain normal body temperature, use an overbed warmer or an Isolette. (If these are unavailable, use a wrapped rubber bottle filled with warm water, but be careful to avoid hyperthermia.) Cover neonate’s head to prevent heat loss.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
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
Weight gain, excessive:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Educating the patient about weight control is extremely important. Stress the benefits of behavior modification and dietary compliance. Help the patient plan an appropriate exercise routine.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Weight loss, excessive:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Refer your patient for psychological counseling if weight loss negatively affects his body image. Teach the patient about his diet and recommend that he keep a food diary. Determine his food preferences and try to incorporate them into his diet. Encourage oral hygiene before meals to make the food more palatable.
» 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
Weight gain, excessive:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Refer the patient for psychological counseling, as necessary.
▪ If the patient is obese or has a cardiopulmonary disorder, monitor exercise closely.
▪ Perform studies to rule out possible secondary causes should include serum thyroid-stimulating hormone determination and dexamethasone suppression testing.
▪ Perform laboratory tests for thyroid function and serum cholesterol, triglyceride, and glucose levels.
Patient teaching
▪ Explain to the patient the cause of weight gain, if known.
▪ Teach the patient about appropriate dietary choices and discuss an individualized exercise plan.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Low birth weight:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Initiate feedings as soon as possible and continue to feed the neonate every 2 to 3 hours.
▪ Provide gavage or I.V. nutrition for the sick or very premature neonate.
▪ Check abdominal girth daily or more frequently if indicated, and check stools for blood to detect necrotizing enterocolitis.
▪ Prepare for a sepsis workup if signs of infection are associated with low birth weight.
▪ Check the neonate's vital signs every 15 minutes for the first hour and at least once every hour thereafter until his condition stabilizes.
▪ Be alert for changes in temperature or behavior, feeding problems, respiratory distress, or periods of apnea—possible indications of infection.
▪ Monitor blood glucose levels and watch for signs and symptoms of hypoglycemia, such as irritability, jitteriness, tremors, seizures, irregular respirations, lethargy, and a high-pitched or weak cry.
▪ If the neonate is receiving supplemental oxygen, carefully monitor arterial blood gas values and the oxygen concentration of inspired air to prevent retinopathy.
▪ Monitor the neonate's urine output by weighing diapers before and after voiding.
▪ Check urine color, measure specific gravity, and test for the presence of glucose, blood, or protein.
▪ Watch for changes in the neonate's skin color because increasing jaundice may indicate hyperbilirubinemia.
Patient teaching
▪ Explain disorder and all procedures and treatments to the parents.
▪ Encourage the parents to participate in their neonate's care to strengthen bonding.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Weight loss, excessive:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Take daily calorie counts and weigh the patient weekly.
▪ Consult a nutritionist to determine an appropriate diet and nutritional supplements with adequate calories.
▪ Administer hyperalimentation or tube feedings to maintain nutrition, as needed.
Patient teaching
▪ Provide instruction in proper nutrition and keeping a food diary.
▪ Instruct the patient in proper oral hygiene.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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