Term
| name the 3 identified eating disorders in the manual of mental disorders? |
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Definition
| anorexia nervosa, bulimia nervosa, and binge eating disorder |
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Term
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Definition
refuses to maintain a minimally normal weight for height and express intense fear of gaining weight.
The term anorexia is a misnomer, because loss of appetite is rare. Some people with anorexia nervosa restrict their intake of food; others engage in binge eating and purging. |
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Term
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Definition
| the patient engages in repeated episodes of binge eating followed by inappropriate compensatory behaviors, such as self-induced vomiting; misuse of laxatives, diuretics, or other medications; fasting; or excessive exercise. |
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Term
| define binge eating disorder |
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Definition
| patients engage in repeated episodes of binge eating, after which they experience significant distress. These individuals do not regularly use compensatory behaviors, such as self-induced vomiting, misuse of laxatives and other medications, fasting, and excessive exercise that are seen in patients with bulimia nervosa. |
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Term
| Although anorexia is found in all cultures, bulimia and binge eating disorder are more common in countries most influenced by what? |
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Definition
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Term
| For women, the lifetime incidence of anorexia nervosa, bulimia nervosa, and binge eating disorder are what? |
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Definition
| 0.9%, 1.5%, and 3.5%, respectively |
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Term
| For men, the lifetime incidence of anorexia nervosa, bulimia nervosa, and binge eating disorder are |
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Definition
| 0.3%, 0.5%, and 2% , respectively |
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Term
| Most eating disorders begin at which age group? |
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Definition
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Term
| what percentage of patients with anorexia nervosa also have OCD disorders? |
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Definition
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Term
| percentage of adult women that are obese in the US |
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Definition
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Term
| percentage of kids aged 2-19 that are obese? |
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Definition
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Term
| percent of the population that develops an eating disorder |
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Definition
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Term
| Although a causal link between cultural norms of thinness and the eating disorders has not been proved, all patients with eating disorders have low ____ ____ that is negatively impacted by their inability to conform to an impossible cultural standard of beauty |
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Definition
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Term
| Do cultural beliefs about physical beauty cause eating disorders? |
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Definition
| No,they influence self-esteem and set the standard of beauty for men and women. If this cultural ideal is unhealthy, it can pose health risks if not addressed. |
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Term
| The patient with anorexia will be severely underweight and may have what growing on them? |
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Definition
| growth of fine, downy hair (lanugo) on the face and back. |
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Term
| name 4 Thoughts and Behaviors Associated with Anorexia Nervosa |
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Definition
• Terror of gaining weight
• Preoccupation with thoughts of food
• View of self as fat even when emaciated
• Peculiar handling of food:
• Cutting food into small bits
• Pushing pieces of food around plate
• Possible development of rigorous exercise regimen
• Possible self-induced vomiting, use of laxatives and diuretics
• Cognition so disturbed that individual judges self-worth by his or her weight |
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Term
| name 5 possible signs and symptoms of anorexia |
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Definition
Clinical Presentation / Cause
Low weight /Caloric restriction, excessive exercising
Amenorrhea /Low weight
Yellow skin / Hypercarotenemia
Lanugo / Starvation
Cold extremities / Starvation
Peripheral edema / Hypoalbuminemia and refeeding
Muscle weakening / Starvation, electrolyte imbalance
Constipation / Starvation
Abnormal laboratory values (low triiodothyronine, thyroxine levels)
/ Starvation
Abnormal computed tomographic scans, electroencephalographic changes / /Starvation
Cardiovascular abnormalities (hypotension, bradycardia, heart failure) / Starvation, dehydration
Electrolyte imbalance
Impaired renal function / Dehydration
Hypokalemia (low potassium) / Starvation
Anemic pancytopenia / Starvation
Decreased bone density/ Estrogen deficiency, low calcium intake |
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Term
| As with any comprehensive psychiatric nursing assessment, a complete evaluation of biopsychosocial function is mandatory. Name 3 possible areas to be covered in the patient's history |
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Definition
• Perception of the problem
• Eating habits
• History of dieting
• Methods used to achieve weight control (restricting, purging, exercising)
• Value attached to a specific shape and weight
• Interpersonal and social functioning
• Mental status and physiological parameters |
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Term
| name 4 possible Medical Complications of Anorexia Nervosa |
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Definition
• Bradycardia
• Orthostatic changes in pulse or blood pressure
• Cardiac arrhythmias
• Prolonged QT interval and ST-T wave abnormalities
• Peripheral neuropathy
• Acrocyanosis
• Symptomatic hypotension
• Leukopenia
• Lymphocytosis
• Carotenemia (elevated carotene levels in blood), which produces skin with yellow pallor
• Hypokalemic alkalosis (with self-induced vomiting or use of laxatives and diuretics)
• Elevated serum bicarbonate levels, hypochloremia, and hypokalemia
• Electrolyte imbalances, which lead to fatigue, weakness, and lethargy
• Osteoporosis, indicated by decrease in bone density
• Fatty degeneration of liver, indicated by elevation of serum enzyme levels
• Elevated cholesterol levels
• Amenorrhea
• Abnormal thyroid functioning
• Hematuria
• Proteinuria |
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Term
| name 3 physical or psychiatric Criteria for Hospital Admission of Patients with Eating Disorders |
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Definition
Physical Criteria
• Weight loss over 30% over 6 months
• Rapid decline in weight
• Inability to gain weight with outpatient treatment
• Severe hypothermia due to loss of subcutaneous tissue or dehydration (temperature lower than 36° C or 96.8° F)
• Heart rate less than 40 beats per minute
• Systolic blood pressure less than 70 mm Hg
• Hypokalemia (less than 3 mEq/L) or other electrolyte disturbances not corrected by oral supplementation
• Electrocardiographic changes (especially arrhythmias)
Psychiatric Criteria
• Suicidal or severely out-of-control, self-mutilating behaviors
• Out-of-control use of laxatives, emetics, diuretics, or street drugs
• Failure to comply with treatment contract
• Severe depression
• Psychosis
• Family crisis or dysfunction |
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Term
| what is usually the most appropriate initial nursing diagnosis for individuals with anorexia |
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Definition
| Imbalanced nutrition: less than body requirements |
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Term
| what is refeeding syndrome |
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Definition
| a potentially catastrophic treatment complication involving a metabolic alteration in serum electrolytes, vitamin deficiencies, and sodium retention |
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Term
| name 2 common cognitive distortions for people with eating disorders |
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Definition
Overgeneralization-A single event affects unrelated situations.
All-or-Nothing Thinking - Reasoning is absolute and extreme, in mutually exclusive terms of black or white, good or bad.
Catastrophizing - The consequences of an event are magnified.
Personalization - Events are overinterpreted as having personal significance.
Emotional reasoning -Subjective emotions determine reality. |
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Term
| How many drugs are FDA approved specifically to treat anorexia? |
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Definition
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Term
| What drug group has proven helpful in reducing OCD behaviors AFTER the patient has reached a healthy weight? |
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Definition
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Term
| what drug is given to delusional or over active anorexia patients? |
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Definition
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Term
| what drug is given to anorexia patients to reduce obsessive behaviors as well as resistance to weight gain? |
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Definition
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Term
| what type of activities include learning more constructive coping skills, improving social skills, and developing problem-solving and decision-making skills? |
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Definition
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Term
| what is the 1 year relapse rate of anorexia patients? |
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Definition
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Term
| what is the long term relapse rate of anorexia? |
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Definition
| 20% even after several years |
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Term
| Assessment signs of Bulimia Nervosa? |
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Definition
Clinical Presentation / Cause
Normal to slightly low weight / Excessive caloric intake with purging, excessive exercising
Dental caries, tooth erosion / Vomiting (HCl reflux over enamel)
Parotid swelling / Increased serum amylase levels
Gastric dilation, rupture / Binge eating
Calluses, scars on hand (Russell's sign) / Self-induced vomiting
Peripheral edema / Rebound fluid, especially if diuretic used
Muscle weakening / Electrolyte imbalance
Abnormal laboratory values (electrolyte imbalance, hypokalemia, hyponatremia) / Purging: vomiting, laxative and/or diuretic use
Cardiovascular abnormalities (cardiomyopathy, electrocardiographic changes) / Electrolyte imbalance—can lead to death
Cardiac failure (cardiomyopathy)/ Ipecac intoxication |
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Term
| Name 5 medical complications of Bulimia Nervosa |
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Definition
• Sinus bradycardia
• Orthostatic changes in pulse or blood pressure
• Cardiac arrhythmias
• Cardiac arrest from electrolyte disturbances or Ipecac intoxication
• Cardiac murmur; mitral valve prolapse
• Electrolyte imbalances
• Elevated serum bicarbonate levels (although can be low, which indicates a metabolic acidosis)
• Hypochloremia
• Hypokalemia
• Dehydration, which results in volume depletion, leading to stimulation of aldosterone production, which in turn stimulates further potassium excretion from kidneys; thus there can be both an indirect renal loss of potassium and a direct loss through self-induced vomiting
• Severe attrition and erosion of teeth, producing irritating sensitivity and exposing the pulp of the teeth
• Loss of dental arch
• Diminished chewing ability
• Parotid gland enlargement associated with elevated serum amylase levels
• Esophageal tears caused by self-induced vomiting
• Severe abdominal pain indicative of gastric dilation
• Russell's sign (callus on knuckles from self-induced vomiting) |
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Term
| Medical evaluation usually includes a thorough physical examination, as well as pertinent laboratory testing, including which tests? |
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Definition
• Electrolyte levels
• Glucose level
• Thyroid function tests
• Complete blood count
• ECG |
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Term
| What is the primary Milieu goal for a bulimic patient? |
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Definition
| its primary goals are the interruption of the binge-purge cycle and the prevention of disordered eating behaviors |
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Term
| What 2 drug classes are shown to help bulimic patients with binge and vomiting? |
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Definition
| SSRIs and Tricyclic antidepressants. |
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Term
| What drug is effective with Bulimic patients but is contrandicated in those who purge, due to an increased risk of seizures? |
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Definition
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Term
| what is the most effective treatment for bulimia nervosa? |
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Definition
| Cognitive-behavioral therapy |
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Term
| what is the difference between Binge Eating Disorder and Bulimia? |
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Definition
| Bulimics tend to purge or over exercise. B.E.D clients do not. |
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Term
| What is the comorbidity of binge eaters and major depression? |
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Definition
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Term
| What medication groups are used to help Binge eating disorder patients? |
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Definition
| SSRI's are the main drug. Tricicylic antidpressants are also used. |
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Term
1. Which female patient should the nurse recognize as having the highest risk to have or develop bulimia nervosa? The one who:
1. grew up in an underserved area.
2. lives in a society influenced by Eastern cultural beliefs.
3. is 20 years old.
4. is African-American. |
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Definition
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Term
2. The nurse is caring for a 16-year-old female patient with anorexia nervosa. What should the initial nursing intervention be upon the patient's admission to the unit?
1. Build a therapeutic relationship.
2. Increase the patient's caloric consumption.
3. Involve the patient in group therapy to build a support group.
4. Self-assess to decrease tendencies towards authoritarianism. |
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Definition
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Term
3. The nurse is caring for a patient with bulimia. Which nursing intervention is appropriate?
1. Monitoring patient on bathroom trips after eating.
2. Allow patient extensive private time with family members.
3. Provide meals whenever the patient requests them.
4. Encourage patient to select foods that she likes. |
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Definition
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Term
4. The nurse is admitting a patient who weighs 100 pounds, is 66 inches tall, and is below ideal body weight. The patient's blood pressure is 130/80 mm Hg, pulse is 72 beats per minute, potassium is 2.5 mmol/L, and ECG is abnormal. Her teeth enamel is eroded, her hands are visibly shaking, and her parotid gland is enlarged. The patient states, “I am really worked up about coming to this unit.” What is the priority nursing diagnosis?
1. Powerlessness
2. Risk for injury
3. Imbalanced nutrition: Less than body requirements
4. Anxiety |
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Definition
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Term
5. The nurse is planning care for a patient with an eating disorder. What outcomes are appropriate? Select all that apply.
1. The patient will experience a decrease in depression.
2. The patient will identify four methods to control anxiety.
3. The patient will collect different kinds of cookbooks.
4. The patient will identify two people to contact if suicidal thoughts occur. |
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Definition
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