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ATI Mental Health > 19 Eating Disorders > Flashcards

19 Eating Disorders Flashcards

1
Q

ED has a _____ rate and ____ risk

A

high mortality; suicide

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2
Q

ED treatment modalities is focused on…

A

normalizing eating patterns + beginning to address issues raised by illness

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3
Q

comorbidities w ED

A
  • depression
  • personality disorder
  • substance abuse disorder
  • anxiety
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4
Q

anorexia nervosa

A

persistent energy intake restrictions leading to significantly low body wt

  • fear of gaining wt/becoming fat
  • disturbance in perceived wt or shape
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5
Q

anorexia characteristics

A

-preoccupied w food, rituals of eating, or refusal to eat

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6
Q

anorexia onset

A
  • assoc w stressful life event

- usually adolescence to young adult

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7
Q

compared to clients w restrictive type, those who have binge/purge type have a higher rate of…

A

impulsivity

-more likely to abuse drugs + alcohol

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8
Q

types of anorexia

A

1 restricting> drastically restricts intake; no binge/purge

2 binge/purge

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9
Q

bulimia nervosa

A

recurrently eat large quantities of food over a short period of time [BINGE]
-then followed by inapprop compensatory behavr [VOMIT/PURGE] to rid of excess calories

**sense of lack of control over earting

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10
Q

bulimia frequency

A

binge/purge occur once a week for 3 months

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11
Q

binge eating is a ___ period of time

A

discrete period of time

-usually less than 2 hr

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12
Q

amount of food during a binge

A

larger than what most individuals eat in similar period of time

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13
Q

bulimia characteristics

A
  • wt within norm range or slightly higher

- bw binges, client typically restricts caloric intake + selects “diet” foods

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14
Q

bulimia types

A

1 purging

2 nonpurging

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15
Q

purging bulimic clients use…

A

SELF INDUCED VOMITING, laxatives, diuretics, enemas to lose/maintain weight

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16
Q

nonpurging bulimics…

A

compensate for eating thru other means

-excessive exercise, laxatives, diuretics, enemas

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17
Q

Binge Eating Disorder

A

recurrently eat large quantities of food over a short period of time w/o use of compensatory behaviors
-severity is based on how often client binges per week

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18
Q

after binge-eating episode, client feels…

A

distress

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19
Q

unlike anorexia + bulimia,

Binge Eating Disorder affects…

A

men + women

  • all ages
  • more commonly 46-55
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20
Q

eating disorder risk factors

A
  • occupational choices that encourage thinness
  • hx of being a “picky” eater in childhood
  • athletics esp in elite level or sport that required lean body (cycling) or specific wt is necessary (wrestling)
  • hx of obesity
  • fam hx
21
Q

biological factors on eating disorder

A

-hypothalamic, neurotransmitter, hormonal, or biochem imbalance, serotonin pathway issues

22
Q

interpersonal relationships on eating disorders

A

influenced by parental pressure + need to succeed

23
Q

psychological influence on eating disorder

A

-rigidity, ritualism
-separation + individuation conflicts
feelings of ineffectiveness, helplessness, + depression
-distorted body image
-internal or external locus of control or self identity
potential hx of phys abuse

24
Q

environmental factors on eating disorder

A

media influence + pressure fr society to have the “perfect body”

25
Q

temperament on eating disorder

A

anxiety or obsessive traits in childhood

26
Q

nursing hx should include…

A
  • client’s perception of issue
  • eating habits
  • hx of dieting
  • methods of wt control
  • value attached to specific wt/shape
  • interpersonal/social functioning
  • difficulty w impulsivity
  • fam + interpersonal relations
27
Q

fam + interpersonal relationships are typically…

A

troublesome, chaotic, + reflecting a lack of nurture

28
Q

cognitive distortions include

A
  • overgeneralization
  • “all or nothing” thinking
  • catastrophizing
  • personalization
  • emotional reasoning
29
Q

example of overgeneralization

A

other ppl dont like me bc im fat

30
Q

example of “all or nothing” thinking

A

if i eat any desert ill gain 50 lbs

31
Q

example of catastrophizing

A

my life is over if i gain weight

32
Q

example of personalization

A

when i walk thru the hallway, i know everyone is looking at me

33
Q

example of emotional reasoning

A

i know i look bad bc i feel bloated

34
Q

ED mental status

A
  • demonstrated high interest in prepping food but not eating
  • fear of gaining wt
  • perceived they are severely overweight + sees image reflected in mirror
  • exhibit low self esteem, impulsivity, + difficulty, w interpersonal relationships
  • need for intense phys regimen
  • guilt/shame due to binging
  • obsessive-compulsive can be related/unrelated to food
35
Q

expected VS

A
  • low BP w possible orthostatic hypotns
  • decr pulse
  • decr temp
  • HTN w binge eating disorder
36
Q

ED weight

A

ANRX: less than 85% of expected norm wt
BLM: wt w/in norm range or slightly higher
BED: typically overweight/obese

37
Q

Anorexia physical apearance

A
  • lanugo (fine hair)
  • pale or yellowed skin
  • cool temp
  • poor skin turgor
  • amenorrhea
38
Q

Bulimia physical appearance

A
  • Russell’s signs (callus/scars on knuckles)
  • enlarged parotid glands
  • dental erosion/caries
39
Q

GI sysem

A
  • constipation (dehydratn)
  • diarrhea (laxative)
  • ab pain
  • self induced vomiting
  • esophageal tears, gastric rupture
40
Q

criteria for acute care tx

A
  • wt loss of 20% of ideal body wt or less than 10% body fat
  • unsuccessful wt gain in outpatient
  • HR<50, BP SYS<90, temp< 96.8
  • ECG changes
  • electrolyte disturbances
  • psych criteria (dprssn, suicdl, dam crisis, psychosis)
41
Q

cognitive-behavioral therapies

A
  • cognitive reframing
  • relaxation techniques
  • journal writing
  • desensitization exercise
42
Q

nursing care

A
  • monitor VS, I+O, wt
  • behavior contracts
  • monitor client before + after meals
  • monitor exercise
  • teach + encourage self-care
  • incorp family when appropriate
  • work w dietician
43
Q

medically acceptable wt gain

A

2-3lb per week

44
Q

diet during care

A
  • consider client’s preference
  • structured/inflexible eating schedule in beginning of therapy> discourages binging
  • small frequent meals is more easily tolerated
  • liquid supplements as prescribed
  • high fiber> prevent constripation
  • low Na> prevent fluid retention
  • limit high fat + gassy food at start
  • admin vitamins + minerals
  • avoid caffeine
45
Q

why should pt avoid caffeine?

A

can incr energy > resulting in difficulty controlling eating disorder behaviors

46
Q

refeeding syndrome

A

potentially fatal complicatn

-can occur when fluids, electrolytes, carbs are introduced to severely malnourished client

47
Q

how to avoid refeeding syndrome

A
  • develop controlled rate of nutritional support in initial tx
  • monitor blood electrolytes
  • admin fluid replacements as prescribed
48
Q

medications

A

fluoxetine: SSRI
onset: 1-3wks (initial), 2 mos (max response)
- avoid hazardous activities
- notify provider if sex dysfunction occurs

49
Q

orlistat med

A

for binge eating to help lose weight

ATI Mental Health (22 decks)

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