Anorexia Nervosa

By: Candice Willingham RN

In today’s society, there seems to be a desperate need to be skinny or to look like the girls on television. Eating disorders have become quite common due to this need. Anorexia nervosa is an eating disorder that compels women to starve themselves in order to lose weight. These women may have an unrealistic body perception and a major fear of becoming fat. Nearly 4% of women now suffer from anorexia (Clark, 2009, p432). The disease typically develops near or during puberty. Anorexia is characterized by excessive dieting, a marked loss of body weight, purging, excessive exercise, and amenorrhea. According to Clark (2008), Anorexia results in mortality rates nearly 12 times higher than the annual death rate for all other causes among women 15-24 years of age.

Primary prevention should be aimed at teaching parents and young girls what the appropriate body size is for their age, promoting proper exercise, giving examples of a healthy diet, promoting adequate rest, explaining the harms of smoking and drinking, helping young girls to develop a strong self image and build self esteem.
Secondary prevention would be promoting annual physicals and pap smears. This will help health care providers notice sudden loss of weight and be able to intervene accordingly. The amount of weight loss determines how aggressive the treatment should be (Harvard, 2009). Women's health care providers are able to assess normal menstrual cycles and explain normal outcomes.
Tertiary prevention would come by helping the female and her family get their lives back together after battling an issue like this. Proper counseling is very important. The counselor can help the patient and the families develop a plan to prevent a relapse.

Clark, Mary Jo. (2008). Community Health Nursing: Advocacy for Population Health (5th Ed.). New Jersey: Pearson
Harvard Mental Health Letter. (2009). Treating Anorexia Nervosa: A Multidisciplinary approach is best, but relapses are common. Harvard Mental Health Letter. 26(2), 1-4.

Note: This blog post reflects the work of Candace Williamson RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Addressing Attention Deficit Hyperactivity Disorder in Children

By: Stephanie Johnson

Does your child have trouble paying attention at home or school? Does he or she exhibit impulsive behaviors? He or she may have a disorder known as Attention deficit hyperactivity disorder (ADHD) formerly known as ADD. ADHD is a chronic condition that affects adults and approximately 5-8% of school age children (NRC, 2009).
Signs and symptoms include excessive talking, difficulty paying attention, losing things, easily distracted, running about or climbing excessively, blurting out answers before question completed, and difficulty remaining seated (NRC, 2009). Children with ADHD tend to perform poorly in school or may be perceived as a nuisance or abnormal.
Primary interventions are focused on educating the public especially caregivers, educators, and families about the disease eliminating the “bad child” stigma that is attached to the condition. Early recognition and diagnosis with parents’ awareness of social disruptions, poor performance in school, and depression may prevent drop out and strained relationships early.
Secondary interventions are aimed at coping with and treating the disorder. ADHD workshops at behavioral health centers offer help with peer adjustment, behavior difficulties, and social and family relationships. Continued parent/child education, behavior management techniques, and stimulant medications are elements of the comprehensive treatment plan (NRC, 2009). The most common stimulant medications used to treat ADHD are Concerta, Adderall and Ritalin. These medications are effective in lessening symptoms and dose adjustments may be necessary.
Tertiary interventions include emotional support for parents, caregivers. The diagnosis of ADHD causes some parents to have feelings of guilt or shame (Clark, 2008).ADHD is chronic and 1/3 of people outgrow the symptoms (NRC). Working with a mental health practitioner, community nurse, ongoing education and support groups aid in maximizing full mental health abilities while attaining a healthy level of well being.

References
National Resource Center on ADHD (NRC).Retrieved from http://www.help4adhd.org/en/about/what.
Clark, M.J. (2008). Community Health Nursing: Adovcacy for Population Health.(5th ed.) Upper Saddler River, New Jersey:Prentice Hall

Note: This blog post reflects the work of Stephanie Johnson RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.

Lead Poisoning

By Krystle Banzuela RN

Lead is both one of mankind’s most useful metals and an environmental health hazard to children 6 years and younger. Lead can be ingested, inhaled, or absorbed through the skin ("Lead in industry," n.d.). Young children are highly susceptible to lead exposure because their nervous systems are not fully developed (Clark, 2008), and because they put everything in their mouth. Lead is in paint, dust, drinking water, and dirt.

Lead poisoning is defined as too much lead in the body that is seen as elevated lead blood level of > 10 mcg/dL (Hockenberry & Wilson, 2009). There is no safe level of lead in the body. At low levels, there are no obvious signs and symptoms of lead poisoning, but it can cause developmental delays, learning problems, and lower attention span. Moderate and high levels can lead to constipation, abdominal pain, poor appetite, anemia, poor appetite, vomiting, irritability, or lethargy. Damage is permanent and non-reversible, however, referral to a child development or speech-language specialist may improve mental abilities.

Below are the suggested lead poisoning prevention activities at the primary, secondary, and tertiary levels, as provided by the Illinois Lead Program (Fokum, Simpson, & Churchill, 2009, p. 26):

Primary Prevention
• Avoid exposure to lead
• Identify sources of lead poisoning like houses with lead based paint
• Focus on high-risk indicators
• Fix highest risk housing
• Evaluate and control hazards
• Educate

Secondary Prevention
• Early detection and intervention prevents progression and emergence of lead poisoning symptoms
• Increase testing rates
• Intervene to reduce risk of long-term damage
• Encourage home visits by public health nurse for case management
• Initiate environmental inspections for lead poisoned cases

Tertiary Prevention
• Damage caused by lead poisoning is irreversible
• Chelate or use chemical compounds that bind to lead to remove toxic metal from the body
• Aim at improving quality of life of lead poisoned children through education
• Eat foods rich in iron and calcium

Lead poisoning has been steadily declining since 1997 from 18.7 % of children in Illinois to 1.7% in 2008 (Fokum, Simpson, & Churchill, 2009), a more than 50% decrease! While this is good news, we should try to get all the lead out and provide a hazard free physical environment for our children. They are the future, and it is our responsibility to provide a safe environment in which they can grow to their fullest potential.

Check out this Get Lead Out Brochures about intervention, prevention, and renovation:
http://www.idph.state.il.us/envhealth/pdf/Lead_Intervention.pdf
http://www.idph.state.il.us/envhealth/pdf/Lead_Prevention.pdf
http://www.idph.state.il.us/envhealth/pdf/Lead_Renovation.pdf

Sources used:
Clark, M. J. (2008). Community health nursing. (5th ed.) New Jersey: Pearson Prentice Hall.
Fokum, F, Simpson, E, & Churchill, S. Illinois Department of Public Health, Illinois Lead Program. (2009). The impact of lead: Illinois lead program annual surveillance report. Springfield, IL.


Note: This blog post reflects the work of Krystle Banzuela RN with minor editing by Shirley Comer RN and was completed as a class assignment. The content of this blog is for informational purposes only. Before beginning or changing a treatment or lifestyle regime you should consult your primary health care provider.