Registered Nurse (RN)
Psychiatric Nursing
Eating Disorders
Bulimia Nervosa Assessment

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Bulimia Nervosa Assessment

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Bulimia Nervosa Assessment

Bulimic-bully and Assess-man
Bulimia nervosa is an eating disorder characterized by a normal body weight coupled with binge and purge episodes occurring at least once per week. Typically, patients with bulimia nervosa will have severe electrolyte imbalances, including hyponatremia and hypokalemia, leading to metabolic alkalosis. The patient with bulimia nervosa may present with parotitis, enamel erosion, and Russell’s sign.
Normal Body Weight
Normal Weight-scale

Bulimia nervosa is characterized by a binge and purge eating habit. Generally, people with bulimia nervosa will have normal or slightly low body weight due to excessive caloric intake combined with purging or excessive exercise.

Binge and Purge
Binge and Puke

One of the defining characteristics of bulimia nervosa is the binge and purge eating habit. Some may use laxatives, diuretics or emetics to expel calories.

Electrolyte Disturbances
Electric-lights Disturbed

Due to increased purging or laxative use, people suffering from bulimia nervosa typically have electrolyte disturbances. It is common for these patients to have hypokalemia and hyponatremia.


Due to extreme electrolyte imbalances and increased purging, alkalosis occurs. Bulimia nervosa leads to alkalosis for a few reasons, one is that acidic content is lost with emesis. Further, if laxatives are used, potassium is lost at increased rates.


Hypokalemia occurs with bulimia nervosa because potassium is lost through the act of purging. In addition, the use of laxatives decreases potassium at increasing rates from the gastrointestinal tract.

Parrot with Parotid-on-fire

Parotitis, or inflammation of the parotid glands, may occur in bulimia nervosa. The main contributing factor to this characteristic is increased levels of serum amylase.

Enamel Erosion
Eroding Teeth

Enamel erosion is a key characteristic of bulimia nervosa. This occurs due to the acidic emesis eroding tooth enamel.

Russell's Sign
Rusted Knuckles

Due to self-induced vomiting, patients with bulimia nervosa may present with calluses, lacerations, or scars on their hands (dorsum or anterior side) and fingers. This characteristic is referred to as Russell’s sign.

Once Weekly For 3 Months
(1) Wand and Week-calendar with (3) Tree Month-moon

To diagnose bulimia nervosa, the patient must engage in at least one episode of binging and purging per week according to the DSM V.


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