Disturbed Thought Processes | Nursing Care Plan for Anorexia/Bulimia

Nursing diagnosis: disturbed Thought Processes related to Severe malnutrition, electrolyte imbalance, Psychological conflicts—sense of low self-worth, perceived lack of control

Possibly evidenced by
Impaired ability to make decisions, problem-solve
Non–reality-based verbalizations
Ideas of reference
Altered sleep patterns—may go to bed late (stay up to binge and purge) and get up early
Altered attention span, distractibility
Perceptual disturbances with failure to recognize hunger, fatigue, anxiety, and depression

Desired Outcomes/Evaluation Criteria—Client Will
Distorted Thought Control
Verbalize understanding of causative factors and awareness of impairment.
Demonstrate behaviors to change or prevent malnutrition.
Display improved ability to make decisions and problem-solve.

Nursing intervention with rationale:
1. Be aware of client’s distorted thinking ability.
Rationale: Allows caregiver to have more realistic expectations of client and provide appropriate information and support.

2. Listen to but avoid challenging irrational or illogical thinking. Present reality concisely and briefly.
Rationale: It is difficult to respond logically when thinking ability is physiologically impaired. Client needs to hear reality, but challenging client leads to distrust and frustration. Note: Even though client may gain weight, she or he may continue to struggle with attitudes and behaviors typical of eating disorders, major depression, and substance dependence.

3. Adhere strictly to nutritional regimen.
Rationale: Improved nutrition is essential to improved brain functioning.

4. Review electrolyte and renal function tests.
Rationale: Imbalances negatively affect cerebral functioning and require correction before therapeutic interventions can begin.