A nursing diagnosis for bulimia nervosa is powerlessness related to feeling not in control of eating habits. The goal for this problem is:
A. Patient will learn problem-solving skills.
B. Patient will have decreased symptoms of anxiety.
C. Patient will perform self-care activities daily.
D. Patient will verbalize how to set limits on others.
Correct Answer: A. Patient will learn problem-solving skills.
If the client learns problem-solving skills she will gain a sense of control over her life. Encourage the patient to take charge of their own life in a more healthful way by making their own decisions and accepting self as she or he is at this moment (including inadequacies and strengths). Patient often does not know what she or he may want for herself. Parents (mother) often make decisions for the patient. Patient may also believe she or he has to be the best in everything and holds self-responsible for being perfect.
Option B: Anxiety is caused by powerlessness. Encourage the patient to express anger and acknowledge when it is verbalized. Important to know that anger is part of self and as such is acceptable. Expressing anger may need to be taught to the patient because anger is generally considered unacceptable in the family, and therefore the patient does not express it.
Option C: Performing self-care activities will not decrease one’s powerlessness. Assist the patient to assume control in areas other than dieting and weight loss such as management of their own daily activities, work, and leisure choices. Feelings of personal ineffectiveness, low self-esteem, and perfectionism are often part of the problem. The patient feels helpless to change and requires assistance to problem-solve methods of control in life situations.
Option D: Setting limits to control imposed by others is a necessary skill but problem-solving skill is the priority. Monitor exercise programs and set limits on physical activities. Chart activity and level of work (pacing and so on). Moderate exercise helps in maintaining muscle tone, weight and combating depression; however, the patient may exercise excessively to burn calories.