Nursing Diagnosis: Anxiety R/T disturbed body image AMB fearfulness of weight gain, and of family discovering eating
habits.
Short Term Goal: The patient will verbalize a reduction in or control of anxiety by 1100 today 9/24.
Long Term Goal: The patient will be able to demonstrate 2 techniques to help reduce anxiety by 1700 today 9/24.
Intervention
Listen to the patient and help them
identify S/S of an anxiety attack.
Reduce environmental stress and
remain with patient during anxiety
attacks.
Identify current activities the patient
uses to reduce stress.
Provide emotional support and
encouragement.
Scientific Rationale
Listening to what the patient says will
help identify anxious behavior and
discover the source. (Sparks, p16)
Anxiety often results from a lack of
trust in the environment and fear of
being alone. (Sparks, p17)
These activities already help the
patient cope with stress. (Sparks, p17)
Improves self concept and patients
attitude about using new techniques
(Sparks, p17)
Implementation
I asked the patient questions about
what they were feeling and how they
felt about these thoughts.
I closed the door to the clients room
because they were agitated by all the
hallway noise. Stayed by their side
and listened to them.
I asked the patient what activities
they enjoyed, or that they liked to do
when they wanted to blow of steam or
get away.
I told the client they were doing a
great job and that they were closer to
reaching their goals.
Evaluation
The patient explained they were
scared of what their parents would
think when they found out they don't
eat. The were also worried about
getting fat on their diet.
The patient indicated they didn’t want
to talk. I told the client I would stay
with them until they felt more
comfortable. They thanked me for
shutting the door because they
“couldn't think.”
The patient indicated they liked to
workout, and go for walks. I
informed them these would be great
things to do to reduce anxiety, but not
to exercise to excessively as it would
be counterproductive.
The Patient smiled and said thanks.
Patient looked excited they were
doing better.
 Relaxation methods will help restore The patient showed me the techniques
I showed the patient some deep
Teach patient a variety of relaxation psychological and physical I taught them on how to relax. Asked
breathing exercises and asked the
techniques equilibrium and reduce anxiety. if I had any other suggestions on how
patient show me how to do them.
(Sparks, p17) to cope.

Short Term Goal Status: Goal was met. Decreased anxiety was visibly seen by change in breathing and reduction of restlessness. Patient also stated she felt much
calmer.

Long Term Goal Status: Goal was met. Patient demonstrated meditation and breathing techniques to help control anxiety.

Nursing Diagnosis: Disturbed body image R/T intense fear of gaining or not being able to lose weight AMB refusal to eat despite nutritional need, patient vocalizing “there are too many calories in
lettuce, I'm going to get fat.”

Short Term Goal: Patient will recognize that what she sees on TV and in magazines is not realistic and by 1100, 9/24
Long Term Goal: Patient will be select and enroll in a treatment facility to continue recovery after discharge by 10/1
Intervention
Assess to what degree the patient’s negative
body image and negative self-concept are related
to overwhelming anxiety.
Encourage the patient to identify the differences
between “real people” and celebrities.
Encourage reexamination of positive and
negative self-perceptions.
Help the patient develop a realistic, acceptable
perception of body image and food.
Refer the patient to individual counseling and a
Scientific Rationale
Patients with anorexia have a distorted body
image.
Patients often use media reports of celebrities
as a guide for their eating behaviors.
The patient needs to develop a realistic
understanding of his or her body image.
Patients must understand the complex health
problems associated with anorexia.
Multiple approaches are needed to achieve
Implementation
I asked the patient about the anxiety they
experienced. I asked what they thought
triggered the anxiety.
I showed the patient pictures of celebrities
without makeup and a comparison of pictures
before and after airbrushing and touch ups
from photo shoots.
After seeing the real version of celebrities, I
had her compare the photos to photos of
herself.
Spoke with the patient about health risks of
her eating habits and asked if she knew where
to find info about healthy foods.
Had a local therapist come and visit with the
Evaluation
Patient said she was afraid if she a an apple
she “would gain 5 lbs because of all the sugar
in fruit, and I already weight 87 pounds.”
The patient was unaware that pictures of
celebrities were so made up. She did not
realize that so much had to be don't to make
them look pretty but they were really no
different looking than an average person.
The patient had never realized how skinny she
was because she had never actually seen what
she looks like but rather what she thought
needed to be fixed.
The patient vocalized want to learn more about
proper nutrition and how to tell if something is
good for your.
The patient was grateful to know there was a

support group for eating disorders.
long-term changes in behavior. Groups that
come together for mutual support and
guidance can provide long-term assistance.
variety of options out there for dealing with
patient about outpatient treatment options for
her problem. Patient agreed to further review
her condition after discharge. Asked the
the materials so she can decide what option is
patient about her support system.
best for her.

Short Term Goal Status: Goal met. Patient verbalized realization of all the work and editing that is done to make celebrities look pretty and thin.

Long Term Goal Status: Goal not met. Patient was still reviewing materials and exploring other treatment options before making a decision. I am confident that the patient will meet the goal by the due
date.