448 Unit 4 NURSINGPRACTICE FORPSYCHIATRICDISORDERS
NURSING CARE PLAN BULIMIA
Nursing Diagnosis
➤Ineffective Coping
Inability to form a valid appraisal of the stressors, inadequate choices of practiced
responses, and/or inability to use available resources.ASSESSMENTDATA
- Inability to meet basic needs
- Inability to ask for help
- Inability to problem-solve
- Inability to change behaviors
- Self-destructive behavior
- Suicidal thoughts or behavior
- Inability to delay gratification
- Poor impulse control
- Stealing or shoplifting behavior
- Desire for perfection
- Feelings of worthlessness
- Feelings of inadequacy or guilt
- Unsatisfactory interpersonal
relationships - Self-deprecatory verbalization
- Denial of feelings, illness, or problems
- Anxiety
- Sleep disturbances
- Low self-esteem
- Excessive need to control
- Feelings of being out of control
- Preoccupation with weight, food,
or diets - Distortions of body image
- Overuse of laxatives, diet pills, or
diuretics - Secrecy regarding eating habits or
amounts eaten - Fear of being fat
- Recurrent vomiting
- Binge eating
- Compulsive eating
- Substance use
continued on page 449EXPECTEDOUTCOMES
Immediate
The client will- Be free from self-inflicted harm
- Identify non–food-related methods of
dealing with stress or crises - Verbalize feelings of guilt, anxiety,
anger, or an excessive need for
control
Stabilization
The client will - Demonstrate more satisfying inter-
personal relationships - Demonstrate alternative methods of
dealing with stress or crises - Eliminate shoplifting or stealing
behaviors - Express feelings in non–food-related
ways - Verbalize understanding of disease
process and safe use of medications,
if any
Community
The client will - Verbalize more realistic body image
- Follow through with discharge
planning including support groups
or therapy as indicated - Verbalize increased self-esteem and
self-confidence