Chapter 18 - Eating & Feeding Disorders Flashcards
What is Anorexia Nervosa? What are unique differences patients with this diagnosis experience?
KNOW THIS!!!
Intense fear of gaining weight
Experience significant differences in:
* How food tastes
* Reduced appetite
* Abnormal feeling of satisfaction after a meal (Satiety)
What do we mean by the term purging when we talk about anorexia nervosa?
a.) Vomiting
b.) Excessive exercise
c.) Using stimulants or other medications
d.) All of the above
d.) All of the above!
Compensatory mechanism where the patient is trying to decrease weight
About control & modification in life
What are the 2 types of anorexia nervosa?
KNOW THIS!!!
- Restricting Type: during the last 3 months, the individual has ** not ** engaged in recurrent episodes of binge-eating or purging behaviors
Binge-Eating: During the last 3 months, the individual ** has ** engaged in recurrent episodes of binge-eating or purging behavior
Comorbidities associated with Anorexia Nervosa
Potential assessment findings in patients with Anorexia Nervosa
- Changes in eating habits
- Hx of dieting or purging
- Methods used to acheive weight control
- Value attached to a specific weight & shape
- Fear of obesity
- Feels fat when thin
- Loss of at least 25% of original body weight
- Amenorrhea
During an assessment, Addie says, “This all started because my mom found out I fainted during gym class. It’s ridiculous”. She seems genuinely unaware that her low weight & other symptoms might be a source of alarm. Addie’s skin is slightly yellow & her skin showed signs of dehydration.
With that fainting spell in mind, to further assess for anorexia nervosa, the school nurse should ask:
a.) “Do you often wear heavy clothing in warm weather?”
b.) “When was your last menstrual period?”
c.) “Do you use any drugs or EtOH?”
d.) “Do you ever lose lapses of time?”
b.) “When was your last menstrual period?”
Amenorrhea is due to the body not having enough storage or nutrients to support a healthy pregnancy
What is hypercarotenemia?
KNOW THIS!!!
Yellow skin color / tint due to increase in keratin
What is Lanugo?
KNOW THIS!!!
Fine, thin body hair
like the hair / fur on a newborn
What is refeeding syndrome?
KNOW THIS!!!
metabolic disturbance (shift in elecrolytes) can occur when a malnourished individual has food introduced too quickly –> can be lethal
Like in holocaust survivors
Can result in: fluid-balance abnormalities, abnormal glucose metabolism, hypophosphatemia, hypomagnesemia, & hypokalemia
Addie’s condition worsens & she collapses at home. She is admitted to your unit with anorexia. You completed your physical & biopsychosocial assessment of her. Which common personality trait is likely to present a particular challenge?
a.) Lack of hygiene & cleanliness
b.) Lack of interest in self & others
c.) Irresistible desire to purge
d.) Perfectionism
d.) Perfectionism
Obsessive compulsive disorder
What medications can be used for the treatment of Bulimia?
KNOW THIS!!!
- Fluoxetine (Prozac)
- Other antidepressants
Also use:
* CBT
* DBT
* Interpersonal therapy (IPT)
* Acceptance commitment therapy (ACT)
Potential physical assessment findings in patients with bulimia
- Normal body weight
- Enlarged parotid glands
- dental erosion & carries (due to acid in the vomit)
- Issues with relationships
- Low self-esteem
What is binge eating?
KNOW THIS!!!
Eating a large amount of food in a certain period of time (i.e. within any 2-hour period) – Binging without purging
Occurs at least 1x per week for 3 months
- Eating to eat (not hungry)
- Eating until they feel uncontrollably full
- Eating alone because they feel embarrassed by how much they eat
- Feeling of disgust, depression, or guilty after eating
Risk Factors for Binge Eating
- Genetic
- Neurobiological
- Cognitive factors
- Environmental Factors: social pressures to be thin
Common assessment findings in patients with binge eating disorder
- Hx of weight cycling
- Hx of binge-eating triggers, foods, & frequency
