Lesson Plan On Eating

Disorders
SUBMITTED TO, SUBMITTED BY,
MS DEEPTHI MSN        MRS RAJANI ACHANTA
LECTURER IIND YEAR MSC NSG
DEPT OF MHN J.M.J. COLLEGE OF NSG
J.M.J. COLLEGE OF NSG
Name of the student teacher : Rajani Achanta
Name of the Guide : Ms Deepthi ( lecturer)
Subject             : Mental Health Nursing.
Unit : VIII Unit.
Name of the Topic : Eating disorders
Group : 3rd year Bsc Nursing Students.
Place : 3rd year Bsc Classroom.
Date :
Time : 8-9 AM
Previous Knowledge : ---
Method of Teaching : Lecture cam Discussion.
Audio visual aids : Black board, OHP, Charts Pamphlets, leaflet.
General Objectives:
By the end of the class the students will acquire adequate knowledge regarding Eating disorders
and they will be able to develop desirable attitude towards theEating disorders and they will be able to practice in their clinical.

Specific Objectives:
By the end of the class the students will be able to Introduce the term eating disorders

 Enlist the types of eating disorders

 Explain in detail about anorexia nervosa.
 Explain the epidemiology of anorexia nervosa
 Enlist the etiological factors.
 Explain about ICD10 crieteria
 Enlist the types of anorexia nervosa
 Enlist the clinical features.
 Enlist the laboratory examinations
 Explain the complications of anorexia nervosa
 Explain the prognosis of the condition
 Explain in detail the management of anorexia nervosa
 Explain nursing interventions for condition
 Define the term Bulimia nervosa
 Explain the epidemiology of Bulimia nervosa
 Explain in detail the nature of Bulimia nervosa
 Enlist the etiological factors of Bulimia nervosa
 Explain the types of Bulimia nervosa
 Explain the signs and symptoms.
 List out the diagnostic finding for Bulimia nervosa
 Explain the complications of Bulimia nervosa
 Explain the treatment modalities for bulimia nervosa
 Explain nursing interventions for condition
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
2min Introduction: OHP
Introduce the term Teacher explained with the
eating disorders Help of O.H.P students
Nutrition is required to sustain life, listened care fully
almost all individuals acquire nutrients from
eating food; there are some 3 disorders assorted
with under eating and over eating and the
psychological behavior also plays potential role
in presentation of these disorders.
Teacher explained with the Pamphlets What are common
2 Enlist the types of help of pamphlet students Eating disorders
min eating disorders Eating disorders: take down the notes
The two most important types of eating disorders
are
Anorexia nervosa
Bulimia nervosa
Explain in detail Teacher explained with the Leaflet What is mean by
5min about anorexia ANOREXIA NERVOSA: help of leaflet students anorexia nervosa
nervosa. • Anorexia nervosa is an eating disorder take down the notes
characterized by self-starvation
– Person’s weight is 85% or less of
normal weight
– Person has an intense fear of
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
gaining weight
– Person has a distorted sense of
their body shape
– In females, anorexia nervosa leads
to a loss of the menstrual period
Explain the
1min epidemiology of OHP What are the
anorexia nervosa EPIDEMIOLOGY: Teacher explained with the epidemiology of
• 0.5% To 1% adolescent in girls. help of O.H.P students anorexia nervosa
listens carefully
• 10 to 20 times more often in females.
• Common age of onset is between 14 and
18 years.
• 65% due to Depression.
• 35% due to social phobia. Charts
Enlist the What are is the
4min etiological factors. Teacher explains with the etiology of anorexia
ETIOLOGICAL FACTORS: help of chart students nervosa
listens carefully
Biological Factors
 Genetic factors
Female siblings’ of patients with
established anorexia nervosa 6 to
10%suffers from the condition compared
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
to the 1-2% found in the general
population of the same age
A disturbance in hypothalamic function
 Social Factors
A. Society Influence
B. Family Influence
Explain about  Psychological & Psychodynamic Factors
3min ICD10 crieteria
Teacher explained with the Blackboard What is the ICD10
ICD 10 CRIETERIA help black board students Criteria?
take down the notes
• Body weight is maintained at least 13%
below
• Self induced vomiting
• Self induced purging excessive exercise
• Use of appetite suppressants and diuretics.
• Elevated level of growth hormone.
• Sequence of pubertal events is delayed in
girls, that is breast do not develop.
• In Boys, the genitals remain juvenile.
• Menarche is late.
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
DSM-IV CRITERIA
 -Anorexia Nervosa Refusal to maintain
weight within a normal range for height
and age (more than 15 percent below ideal
body weight)
• Fear of weight gain
• Severe body image disturbance in which
body image is the predominant measure
of self-worth with denial of the
Enlist the types of
5mts anorexia nervosa seriousness of the illness
• In postmenarchal females, absence of the Blackboard What are the types
Teacher explains with the of anorexia
menstrual cycle, or amenorrhea (greater help of black board nervosa
students take down the
than three cycles).
notes.
TYPE:
Two types of anorexia nervosa:
• Restricting type: loses weight by
severely limiting the amount of food
consumed
• Binge-eating-purging type: engages in
binges (large amount of food consumed)
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
following by purging (vomiting or use of
laxatives)
Enlist the clinical • Lifetime prevalence of anorexia nervosa
2mts features. OHP What are the
is less than 1% and is 10 times more Teacher explains with the clinical features for
frequent in women than in men. help of O.H.P students anorexia nervosa
take down the notes

CLINICAL FEATURES:
• Intense fear of becoming obese.
• Body weight is 15% below the standard
weight.
• Body image disturbance.
• Sensitivity to cold.
Enlist the Black board
1min laboratory • Low Blood Pressure Teacher explains with the What are the
examinations • Brady Cardia help of black board laboratory
students take down the Diagnosis for
• Vomiting notes. anorexia nervosa
• Electrolyte imbalance

LABORATORY EXAMINATIONS:
What are the
Explain the Black board
2min • Physical Examinations complications of
complications of Teacher explains with the
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
anorexia nervosa • Complete Blood Testing help of black board anorexia nervosa
students take down the
• ECG
notes
• Differential Diagnosis.

COMPLICATIONS:

 Increased susceptibility to infection

 Hypoalbuminia
 Cachexia
 Cardiac effects
Explain the Black board
1min prognosis of the  Digestive and gastro intestinal Teacher explains with help What is the
condition of black board students prognosis of the
 Reproductive
take down the notes. condition
 Dermatological
 Hematological
 Skeletal

COURSE AND PROGONOSIS OHP

Explain in detail
3 the management of
min anorexia nervosa
• It varies greatly spontaneous recovery Teacher explains with the
help of OHP and students What is the guide
without treatment line to be followed
take down the notes.
• Op recovery after a variety of treatment in managing
anorexia nervosa
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
• Death caused by complications of
starvation

TREATMENT MODALITIES
PHARMACOTHERAPY
 Neuroleptics
 Appetite stimulants

3min Explain nursing  Antidepressants OHP

interventions for  Psychological therapies What are the
condition Teacher explains with the nursing
 Individual therapy help of OHP and students interventions for
take down the notes. condition
 Behavioral therapy
 Cognitive behavioral therapy
 Family therapy

NURSING INTERVENTIONS
• Maintain a strict intake and output chart
• Monitor status of skin and oral mucosa
• Encourage the patients to verbalize
feelings of fear and anxiety
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
• Encourage the patients to participate in
health education.
• Avoid discussion that focus on food and
weight
• Eating must be supervised by nurse and a
balanced diet of at least 3000 calories
should be provided in 24 hours
• In early stages of treatment it is best for
the patient to remain in bed in single room
while close observation
• The goal should be achieve a weight gain
of 0.5 to 1 kg/week.
2min Define the term
Bulimia nervosa • Weighed should be checked regularly.
Monitor serum electrolyte levels and signs OHP What is meant by
Bulimia nervosa
and symptoms like constipation, Teacher explains with the
help of OHP and students
hypoglycemia, hypotension etc
take down the notes.
• In extreme cases when the patients refuses
to eat and comply with the treatment,
gavage feeding may need to instituted.
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
What are the
2min Explain the OHP epidemiology
epidemiology of BULIMIA NERVOSA factors of Bulimia
Bulimia nervosa Teacher explains with the nervosa
help of OHP and students
DEFINITION: take down the notes.

Bulimia nervosa is characterized by

3min Explain in detail episodes of binge eating followed by feeling of Explain in detail
the nature of Black board the nature of
guilt and ,depression includes frequent use of
Bulimia nervosa Bulimia nervosa
compensatory measures to prevent weight gain. Teacher explains with help
of black board students
take down the notes.
EPIDEMIOLOGY:
• More prevalent than anorexia nervosa
• More seen in young women
• It occurs in late adolescence or adulthood
• Females are more prone to anorexia
nervosa
2min OHP

The Nature of Bulimia Nervosa Teacher explains with the

help of OHP and students What are the
 90-95% are Women take down the notes. etiological factors
of Bulimia nervosa
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
 White; Middle-to-Upper Middle Class
.
 Onset 16-19 Years of Age

2min  6-8% College Women OHP

Enlist the  About 1% of Female Population Overall
etiological factors
of Bulimia nervosa  Chronic if Left Untreated Teacher explains with the
help of OHP and students What are the types
 Co-morbidity with Substance Abuse take down the notes. of Bulimia nervosa

Etiology
2min
 common in first degree , biological Black board
relatives of people with bulimia
Explain the types of
Bulimia nervosa  family disturbances or conflict Teacher explains with the
 learned maladaptive behavior help of black board and
students take down the What are the signs
 Struggle for control or self identity. notes. and symptoms.

TYPES

Explain the signs • PURGING TYPE: person regularly

and symptoms. engaged in self induced vomiting or the
miss use of laxatives ,diuretics, enemas
• NON-PURGING: person has used other
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
inappropriate compensatory behaviors.

SIGNS AND SYMPTOMS

• Mouth sores
• Pharyngeal trauma
• Dental caries
• Heartburn, chest pain
• Esophageal rupture
2min
• Impulsivity: Black board
– Stealing
– Alcohol abuse Teacher explains with the
help of black board and What are the
– Drugs/tobacco students take down the diagnostic finding
notes for Bulimia nervosa
• Muscle cramps

2min • Weakness Black board

List out the • Bloody diarrhea
diagnostic finding
for Bulimia nervosa • Bleeding or easy bruising Teacher explains with the
• Irregular periods help of black board and
students take down the What are the
• Fainting notes complications of
• Swollen parotid glands Bulimia nervosa
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
• hypotension

Explain the DIAGNOSIS

complications of
Bulimia nervosa • Physical Examinations
• Complete Blood Testing
2min • ECG
• Differential Diagnosis. O.H.P

Teacher explains with help

of O.H.Pstudents take What are the
COMPLICATIONS down the notes. treatment
modalities for
 Gastric rupture during periods of binge bulimia nervosa
5min eating.
 Dental caries ,erosion of tooth
Explain the O.H.P
treatment enamel,parotitis and gum infections.
modalities for  Dehydration or electrolyte imbalances. Teacher explains with help
bulimia nervosa of O.H.P students take What are the
 Chronic, irregular bowel movements and down the notes. nursing
interventions for
constipation from laxative use.
condition
 Increased risk of suicide and psychoactive
substance abuse.
Explain nursing
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
interventions for TREATMENT
condition
 Psychotherapy
 Cognitive-behavioral therapy
 Dynamic psychotherapy
 Pharmacotherapy

Nursing interventions:
 Engage patient in therapeutic alliance to
obtain commitment to treatment.
 Establish contract with patients that
specifies amount and type of food she
must eat at each meal.
 Set a time limit for each meal
 Identify patients elimination patterns
 Explain risk of laxative,emeticand diuretic
abuse
 Provide assertiveness training
 Assess and monitor patient’s suicide
potential.
Teacher explains with the
help of
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities

Students take down the

notes.

Teacher explains with the

help of OHF and students
take down the notes.

Teacher explains with the

help of black board and
students take down the
notes

Teacher explains with the

help of discussion and
students take down the
note.
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities

Teacher explains with the

help of OHP and students
take down the note.

Teacher explains with the

help of OHP and students
take down the notes.

Teacher explains the

victims of discaster with
help of discussion and
students take down the
notes

Teacher explains with the

help of discussion and
students take down the
notes.
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities
Time Specific Objective content Teaching& Learning Av aids Evaluation
Activities

Teacher explains with the

help of black board and
students listens carefully

Teacher explains with the

help of black board
students listen actively.
Assignment:
What are the common eating disorders and explain two in detail with management.
Conclusion:
Eating disorders is a condition which needs immediate intervention to safeguard the life of the patient, bring down the anxiety of family
members and enhance emotional security to other in the environment. I thank Madam deepthi for giving me Opportunity to complete my
teaching practice.
Bibliography:

 R. Sreevani, a textbook of Mental Health Nursing psychiatric Nursing 2nd volume 3rd edition Jaypee publications Page No – 253.
 Bimila Kapoor 1994 a text book of psychiatric Nursing volume II 11th edition’s Kumar Publications.
 Ram Kumar Gupta “Mental and Health Nursing VICA’s and company Medical Publication 10th edition page no – 286.
 Mary werghese essentials of psychiatric and Mental health nursing 3rd edition Page no 256.