lost through vomiting

Other Drugs: Some experts recommend the use of monoamine oxidase Inhibitors (tranylcypromine sulfate, phenelyzine sulfate). Drugs that facilitate serotonergic neurotransmission such as fluoxetine, sertraline hydrochloride, and paroxetine may be used. Other drugs may be used such as tricyclic antidepressants, nortriptyline hydrochloride, or desipramine hydrochloride.


Teach the patient to choose correct portion sizes. Encourage the patient to eat slowly and avoid performing other activities such as reading or watching television while eating. Most patients are encouraged not to use diet foods or drinks until a stable body weight is established. Encourage the patient to eat a low-sodium diet to prevent fluid retention. Fluid retention is common until the body readjusts its fluid balance; the patient may need support if she or he experiences edema of the fingers, ankles, and face. As he or she begins to eat and drink normally, support the patient if he or she becomes upset about weight gain and reassure the patient that the weight gain and swelling are temporary. Also encourage the patient to establish a normal exercise routine but to avoid extremes.

The goals of nursing interventions are to enhance self-esteem, facilitate growth in independence, manage separation from the family, develop sexual identity, and make career choices. Explore ways for the patient to identify and express feelings, manage anger and stress, develop assertive communication skills, and control impulses or delay gratification. Help the patient learn ways to cope with feelings of anxiety and depression, as opposed to binging and purging.

Explore ways to reduce the patient's vomiting, laxative, and diuretic abuse. Some patients respond well to contracting or behavioral management to reduce these behaviors. Educate the family about appropriate nutrition. Explore ways the family can manage conflict, and support the patient's move toward independence.

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