V. Analysis/nursing diagnosis—body image development disturbance may be related to:

• A. Obvious loss of a major body part—amputation of an extremity, hair, teeth, eye, breast.

• B. Surgical procedures in which the relationship of body parts is visibly disturbed—colostomy, ileostomy, gastrostomy, ureteroenterostomy.

• C. Surgical procedures in which the loss of body parts is not visible to others—hysterectomy, lung, gallbladder, stomach.

• D. Repair procedures (plastic surgery) that do not reconstruct body image as assumed—rhinoplasty, plastic surgery to correct large ears, breasts.

• E. Changes in body size and proportion—obesity, emaciation, acromegaly, gigantism, pregnancy, pubertal changes (too early, too late, too big, too small, too tall).

• E Other changes in external body surface—hirsutism in women, mammary glands in men.

• G. Skin color changes—chronic dermatitis, Addison’s disease.

• H. Skin texture changes—scars, thyroid disease, excoriative dermatitis, acne.

• I. Crippling changes in bones, joints, muscles— arthritis, multiple sclerosis, Parkinson’s.

• J. Failure of a body part to function—quadriplegia, paraplegia, cerebrovascular accident (CVA).

• K. Distorted ideas of structure, function, and significance stemming from symbolism of disease seen in terms of life and death when heart or lungs are afflicted—heart attacks, asthmatic attacks, pneumonia.

• L. Side effects of drug therapy—moon face, hirsutism, striated skin, changes in body contours.