Editing Mental Health and Psychosocial Nursing (section)

== Eating Disorders ==
* '''Anorexia nervosa''': restriction of intake leading to significantly low body weight, intense fear of weight gain, and disturbed body image. Findings include bradycardia, hypotension, hypothermia, amenorrhea, lanugo, dry skin, and osteopenia.
* '''Bulimia nervosa''': binge eating with compensatory behaviors, usually at or above normal weight. Findings include '''hypokalemia and metabolic alkalosis''' from vomiting, dental enamel erosion, parotid enlargement, and Russell's sign (calluses on the knuckles).
* '''Binge-eating disorder''': bingeing without compensatory behavior.
* '''Avoidant/restrictive food intake disorder''': restriction without body image disturbance.

Nursing care: weigh at the same time daily, after voiding, in a gown, with the client's back to the scale; monitor for water loading and hidden weights. Supervise meals and remain with the client for at least 1 hour afterward. Set out a structured contract linking privileges to intake and weight goals. Address the underlying issues of control and perfectionism rather than arguing about food.

'''Refeeding syndrome''' is the key safety concern when nutrition is restarted in a severely malnourished client: an insulin surge drives phosphate, potassium, and magnesium intracellularly, producing '''hypophosphatemia''', hypokalemia, hypomagnesemia, fluid overload, arrhythmias, and heart failure. Refeed slowly, monitor electrolytes and cardiac rhythm, and replace phosphorus.