Patient with a first admission to the eating disorders unit. Anorexia nervosa: nursing approach

Abstract

Anorexia nervosa manifests as a refusal to maintain a body weight within normal limits, with body image distortion, phobia of weight gain and excessive preoccupation with physique; the DSM-5 differentiates the restrictive and compulsive/purging types. We present the case of a patient with anorexia nervosa admitted for the first time to an eating disorders unit, referred from the day hospital due to the impossibility of management, with a BMI of 15.5 kg/m², no awareness of illness, rejection of body image, agitation and hetero-aggression in the context of dysfunctional family relationships. After assessment according to Marjory Gordon’s functional health patterns, a care plan was developed with the NANDA, NOC and NIC taxonomies (ineffective health maintenance, imbalanced nutrition, disturbed body image, anxiety and ineffective coping), complemented with a behavioural contract and therapeutic privileges linked to weight gain and with psychoeducational groups. In the evaluation, the objectives of health-seeking behaviour and diet adherence were achieved, with body image distortion and fear of relapse persisting at discharge, underlining the efficacy of cognitive-behavioural therapy and the need for continuity of care.