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Fluid Volume Deficit - NCP for Bulimia Nervosa

Nursing Care Plan for Bulimia Nervosa

Bulimia nervosa is an eating disorder characterized by binge eating and purging, or consuming a large amount of food in a short amount of time followed by an attempt to rid oneself of the food consumed (purging), typically by vomiting, taking a laxative, diuretic, or stimulant, and/or excessive exercise, because of an extensive concern for body weight.


Signs

These are some of the many signs that may indicate whether someone has bulimia nervosa:
  • fixation on number of calories consumed
  • fixation on and extreme consciousness of weight
  • low self-esteem
  • low blood pressure
  • irregular menstrual cycle
  • constant trips to the bathroom
  • depression
  • frequent occurrences involving consumption of abnormally large portions of food

Nursing Diagnosis and Interventions :

Fluid volume deficit related to excess output

Goal: Lack of body fluid volume can be met.

Expected outcomes:
  • Vital signs within normal limits
  • Intake and output balance.
  • Abdomen not sunken.
  • Mucous membranes moist.
  • Skin turgor back within 3 seconds.
  • No vomiting.
  • Laboratory results: Na: 135 -145 mEq / L, Ca: 4-5 mEq / L, K: 3.5 - 5.3 mEq / L

Interventions :
  • Assess vital signs: pulse, status mucous membranes, skin turgor.
  • Assess the amount of fluid intake (intake and output).
  • Identify a plan to improve / maintain fluid balance.
  • Observation excessively dry skin and mucous membranes, decreased skin tugor.
  • Give fluids according to indications.
  • Auscultation bowel sounds.
  • Assess the laboratory examination of the electrolyte.
  • Measure body weight per day.
  • Assess the patient's history or the nearest person, in respect of the duration of vomiting.
  • Assess the temperature, skin color, skin moisture.
  • Collaboration intravenous fluids.
  • Apply boundaries with clients about eating habits.
  • Encourage clients to eat with other clients or their families, if tolerated.

Rational :
  • Circulation volume adequacy indicator.
  • To enter the calories that affect electrolyte balance.
  • Involving patients in a plan to correct the imbalance.
  • Shows the fluid loss.
  • Pay attention to circulating volume and electrolyte balance.
  • Prevent infection of the digestive tract.
  • Provide information about the circulation volume, electrolyte balance.
  • Measuring the adequacy of fluid replacement.
  • Assist in estimating the total volume shortfall.
  • Indicate dehydration.
  • To avoid dehydration of the body.
  • Preventing overeating behavior that includes eating secretly and swallow food, helps clients quickly and return to normal diet (three times daily).
  • Prevent secrecy about eating, though at first anxiety, the client may be too high to join the meal together.
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