_ch. 14 - Eating Disorders Flashcards
Characteristics of anorexia
+ Onset early adolescence
+ body image distortion
+ drive for thinness
+ excessive dieting, purging, exercise
+ possible use of laxatives, diuretics
+ absence of at least 3 menstrual cycles
+ Judges self worth by weight
+ severe weight loss — less than 85% of normal body weight
+ perfectionism
+ typically female - white, hispanic
Two types of anorexia
+ Restricting type
+ binge eating / purging type
Risk factors for anorexia
+ low, self-esteem, body to satisfaction
+ family: over protective, and mashed, rigid, conflict, driven
+ elite athletes
+ chronic exercisers
anorexia physical assessment
+ low weight
+ lanugo
+ yellow skin
+ cold extremities
+ peripheral edema
+ vital signs: low BP 70/40, low pulse, low temperature
Anorexia assessment: mannerisms & behaviors
+ Regular headaches – dehydration
+ diet talk
+ avoids eating with certain people, or in front of people
+ forces self to exercise when Tired / injured
+ Judges people based on what they eat
+ only meets people for coffee or tea – no calories
+ only eat out when they know everything in the meal
+ Makes excuses for canceling plans
High priorities to look out for when anorexia patient admitted
+ Cardiac arrest
+ fainting/falling
+ refeeding syndrome
Weight goal for anorexic person?
What is considered severe weight loss?
+90% of ideal weight
+75% of ideal weight
Medication‘s to treat anorexia
+ Fluoxetine – SSRI
+ olanzapine/Zyprexa – may improve body, weight, cognition, body image
Treatment for anorexia – medical, therapeutic
+ medical Treatment: addresses acute complications – electrolyte imbalance, cardiac problems,
+ psychiatric therapy: milieu therapy to focus on normalizing eating
+ to get goal weight to 90%
+ family therapy, individual therapy, cognitive therapy
Initial nursing actions for anorexia
+ Recognize Pts fear of weight gain
+ provide empathy
+ develop therapeutic alliance
Implementation/teaching for anorexia
+ Coping skills: self-care activities, improving social skills, decision making skills
+ therapeutic milieu: focuses on precise meal times, adherence to menu, observation, during/after meals, schedule weights, privileges/rewards for weight gain
Describe refeeding syndrome, symptoms to look for
+ Fasting causes depletion of minerals as body tries to conserve muscle/protein
- Introducing food causes increase in BMR, increased protein, and fat synthesis
- body doesn’t have enough minerals/electrolytes for demands to synthesize fat/protein
- Dramatic shift of fluids/electrolytes
- serious complications
- dangerous refeeding symptoms begin: weakness, shortness of breath, seizures, mental confusion, cardiac arrest, heart failure, coma, death
+ Monitor patients during feeding rehabilitation to avoid complications!
- start with low calories avoid refeeding
Characteristics of Bulimia
+ Recurrent episodes: binge, eating/purging, laxatives, diuretics, emetics, fasting/non-purging, over exercising
+ Episodes at least once a week for three months
+ no severe weight loss, outward change in appearance or amenorrhea
+ self-evaluation influence by weight – feeling fat
+ Overwhelmed/overly committed people
+ difficulty setting limits and boundaries
+ social butterflies, highly socially, driven
+ shame, guilt, discussed about binging and purging
+ impulsivity and other aspects of life
Egosystonic & egodystonic - which is anorexia, and which is bulimia
+ anorexia is egosystonic: they think they are fat so they are acting in a way that decreases body weight
+ bulimia is egodystonic: they think they are fat, but they know what they’re doing is wrong
Comorbid conditions for eating disorders
+ Depression
+ OCD
+ substance-abuse
