Final Project - NCM 117L

NCM 117 LAB Final Project Care of Clients with Maladaptive Patterns of Behavior, Acute and Chronic Mercado, Kianna BSN - 3201

How to care for clients with: • Eating Disorders • Substance Use Disorder

Eating Disorders • Anorexia Nervosa • Bulimia Nervosa • Binge-Eating Disorder Substance Use Disorder • Alcohol • Sedatives, hypnotics, anxiolytics • Opioids • Inhalants • Hallucinogens • Stimulants (amphetamines, cocaine, metamphetamine) • Cannabis

Anorexia Nervosa — Manifesting oneself through depriving the body of food, Anorexia Nervosa is characterized by low body weight and body image distortion with an obsessive fear of gaining weight. Additionally, it often coincides with increased levels of exercise and is a psychological illness that has devastating physical consequences. “I am not hungry”

How is care given to patients with anorexia nervosa? • Monitor the patient's food intake, skin condition, elimination pattern, and activity levels • Observe the patient's nutritional status • Maintain adequate nutrition and electrolyte imbalance • Encourage the patient to eat during mealtimes and supervise them after • Set time limits for each meal in a relaxed environment/atmosphere to reduce stress • Set realistic expectations to reduce anxiety • Educate the patient about the treatment for anorexia nervosa - be it psychological or physical “ To generally start what I have learned about taking care of patients with eating disorders, it is important for nurses to have knowledge and understanding about where the patient's perspective, thoughts, and feelings are coming from. Identifying the causes for having the condition is critical to assess the patient’s current status. I have realized that nurses should be non-judgmental and accepting of patients through building a trusting relationship. Specific to patient’s with anorexia nervosa, it is important to consider why the patient is having distorted perceptions of themselves while therapeutically applying the nursing interventions to help them have or return to a healthy weight by learning about the nutrition they really need. ”

BULIMIA — To undo or compensate for the effects of binge eating, Bulimia Nervosa is characterized by a cycle of bingeing and compensatory behaviors such as self-induced vomiting. Moreover, it is considered as a serious and potentially life-threatening eating disorder. • Build rapport and accept the patient as a worthwhile individual • Do not make the patient feel rejected • Identify the feelings and situations which are associated with or that triggers their binge- eating • Develop their strength to cope with problems • Encourage the patient to discuss their positive qualities to improve and increase their self esteem, to adhere to eating on time, and participating in group activities and therapies • Assist the patient to explore positive or alternative ways to cope with their environment as they recover from their condition

Nervosa “ Most patients with bulimia nervosa are aware about their condition and given that they feel helpless as they are unable to control themselves during their binge- eating episodes, they would want to seek for help to address their situation. On the other hand, their intense desire to please people may cause manipulative behaviors that may affect the nurse's assessment and interventions. Patients with this kind of disorder will be more open and honest if they would not feel that they will receive punishment upon disclosing their problem, feelings, and perspectives. It is important for them to gain more support and to live in an environment with healthy behavioral patterns. ”

[ Binge-Eating Disorder — Often very quickly and to the point of discomfort, recurrent episodes of eating large quantities of food is one of the characteristics of Binge eating disorder (BED). During the binge-eating episodes, the patient has a feeling of a loss of control, experiences shame, distress, and/or guilt afterwards. Additionally, patients with this condition do not regularly use unhealthy compensatory measures like purging to counter their binge-eating. It is severe and life-threatening but is treatable.

• Support and assist the patient to eat regular meals • Address emotional factors (anxiety, depression, and self-esteem) to identify the source • Help the patient recognize when they are hungry so they won't reach the point of being overly hungry • Encourage the patient to keep a food journal • Encourage the patient to consider therapies such as • Cognitive Behaviour Therapy Enhanced (CBT-E) • Cognitive Behaviour Therapy – Guided Self Help (CBT-GSH) • Interpersonal Therapy (IPT) (4) “ For patients with binge-eating disorder, they may experience a lot of physical, mental, and emotional effects just like any other eating disorders. It may really take over one's life and the struggles they may face may affect their whole being. It is very important to have an eating plan and to recognize the nutritional content of every food they intake. We should help the patients find their triggers to help them recognize the signs to prevent their binge-eating episodes. Additionally, we must teach them healthy ways to cope up with their feelings so that they will start to understand and learn how to manage their weight and overall health in healthy ways. ”

SUBSTANCE USE — A substance use disorder (SUD) leads to a person's inability to control their use of substances such as alcohol, sedatives, hypnotics, anxiolytics, opioids, inhalants, hallucinogens, stimulants, and cannabis as it is a mental disorder that affects a person's brain and behavior.

DISORDER • Examine the patient's background and the anything that is related (that may be a causative factor) to their substance abuse • Let the patient know what their condition is and how it is related to their problems • Do not invalidate the patient's feelings and perspectives as they verbalize it • Always be honest and open to the patient • Educate and explain the consequences of the substance abuse • Observe their behavioral changes • Encourage the patient to have healthy coping mechanisms and improve their social skills • Encourage the patient to attend individual and group therapies or self-help/support groups

This mental health issue is kind of personal for me as I have somehow almost experienced it myself. It is very important to pin-point what causes the substance abuse so that it will be easier for the nurse to address the condition. A year or two ago, I became dependent in using sleeping pills not just to actually fix my sleeping patterns but because of its effects which makes my brain altered and I just function without feeling much emotion. Having that said, I can understand those with substance use disorder not only from studying but also from a personal point of view. It is very important to consider where the person is coming from so the nurse would know exactly what to do for the patient to cope in healthier ways.

Just like any other mental health conditions, this kind of disorder may impair the person's ability to function in day-to-day life. It does not only affect the patient but also the people around them as the substance abuse impact their social functioning. It contribute to medical or psychiatric conditions, disability, and death which influences and affect our society. As this disorder affects the patient's judgement, insight, self-esteem, performance, relationships, and nutrition, it is our goal to promote abstinence and carry out effective aftercare plans for the patient.

NCM 117 LAB Final Project Care of Clients with Maladaptive Patterns of Behavior, Acute and Chronic Mercado, Kianna BSN - 3201