2025-09-23·8 min read·Mental Health
Eating Disorders: Anorexia and Bulimia Nursing Care for the NCLEX
Assessment, medical complications, and nursing interventions for anorexia nervosa and bulimia nervosa.
Anorexia Nervosa
- Restrictive eating, intense fear of weight gain, distorted body image
- BMI <17.5, amenorrhea, lanugo, hypothermia, bradycardia
- Complications: cardiac arrhythmias, osteoporosis, electrolyte imbalances
- Most dangerous complication: refeeding syndrome - occurs when restarting nutrition too quickly. Monitor phosphorus levels
Bulimia Nervosa
- Binge eating followed by purging (vomiting, laxatives, excessive exercise)
- Often normal weight or slightly overweight
- Signs: Russell's sign (calluses on knuckles), dental enamel erosion, parotid gland swelling
- Complications: metabolic alkalosis (from vomiting), esophageal tears, electrolyte imbalances
Nursing Interventions
- Monitor during and 1-2 hours after meals (prevent purging)
- Set clear expectations around mealtimes
- Monitor electrolytes, especially potassium
- Refeeding: start slowly, monitor for fluid overload and electrolyte shifts
- Build therapeutic relationship - focus on feelings, not food
- Avoid power struggles over eating
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