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Nursing 232- Exam 2 > Eating Disorders > Flashcards

Eating Disorders Flashcards

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1
Q

What is Pica?

Who/What is this associated with?

A
  • Ingestion of non-food substances/repeated Regurgitation and spitting out
  • Children/Pregnant women
  • Associated with parent/child conflict
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2
Q

Eating disorders have periods of symptom ____ and ____. What often causes exacerbation?

A
  • Periods of remission and exacerbation

* Exacerbation often caused by ANXIETY

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3
Q

Cognitive symptoms such as _____ are often the last to ____. Usually precede the onset of what actions?

A
  • Obsessions w/ food and weight
  • Last to remit
  • Precede restricting, binging, and purging.
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4
Q

What does the time to remission of symptoms usually depend on? Which disorder has a longer time to remission?

A
  • Depends on severity of disease

* Anorexia has longer duration to remission period than bulimia

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5
Q

2 Most common causes of death in eating disorder illness?

A
  • Suicide

* Cardiac failure

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6
Q

3 components of biological etiology for eating disorders?

A
  • Genetics (11x risk for anorexia, 4x risk for bulimia)
  • Disruptions to hypothalamus relating to hunger and satiety.
  • Neurochemical changes
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7
Q
  • Abnormalities in ___ receptors and concentration is a neurobiological factor of_____.
  • Abnormalities in ____ which inhibits pleasure seeking behaviors.
A
  • Serotonin
  • Anorexia nervosa
  • Dopamine
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8
Q

What hormone plays role in modulating serotonin activity? What is seen as a result?

A
  • Estrogen

* Anorexia is more prevalent in women

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9
Q

Etiology of eating disorders?

  • Struggle with ____/_____
  • ______ families
  • ____ ____ disturbances
  • _____ factors (media)
A
  • Identity/autonomy
  • Enmeshed families/Family dysfunction
  • Body image disturbances
  • Sociocultural (Media, pressure from others)
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10
Q

What are the peak periods for onset of eating disorders? Examples?

A
  • Developmental periods indicative of change (Can be stressful)
  • Transition in schools (elementary to middle and middle to high)
  • Puberty
  • Transition to independent living
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11
Q

Where is there an increased prevalence in eating disorders?

A

*Industrialized countries

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12
Q

What is used to diagnose eating disorders and view their patterns, besides body weight?

A

*Various standardized screening tools

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13
Q

What are 5 aspects to look at when screening for eating disorder?

A
  • Height/Weight and changes in weight
  • Menstrual history (any pauses)
  • Determine body image
  • Obsession w/ counting calories and dieting
  • Type/amount and frequency of exercise
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14
Q

A current biologic theory states that eating disorders stem from a disruption to what?

A

*Hypothalamus

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15
Q

Common psychological symptoms of Anorexia?

A
  • FEAR of gaining weight/being fat
  • REFUSAL to maintain normal body weight
  • DISTURBED perception of body image
  • DENIAL that there is a problem/hiding problem (baggy clothes)
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16
Q

Usual onset of anorexia?

A

Ages 14-18 (but sometimes younger)

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17
Q

What are five physical characteristics of someone with anorexia?

A
  • Low body weight
  • Skin is yellow
  • Lanugo
  • Cold extremities
  • peripheral edema
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18
Q

What issue might be seen with the GI system with Anorexia?

A

*Constipation

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19
Q

What issue may be seen with the reproductive system in anorexia?

A

*Amenorrhea

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20
Q

What are three cardiac complications that may be seen with anorexia?

A
  • Hypotension
  • Bradycardia
  • Hypokalemia
21
Q

What are 3 Labs that may be seen in Anorexia?

A
  • Hypokalemia
  • Low levels of TRH (T3,T4)
  • Decreased bone mineral density
22
Q

Three points of medical management for anorexia?

A
  • Nutritional/Fluid and Elyte restoration
  • Psychopharmacology
  • Therapy - Psycho, Family, Individual, cognitive behavioral
23
Q

Binge eating in bulemia is usually done in____. Followed with compensatory behaviors to avoid____. These include what? Feelings of ____and ___ follow.

A
  • Done in secret
  • Avoid Weight gain
  • Purging - vomiting, laxatives, diuretics, fasting, excessive exercise, insulin, thyroid medication
  • Guilt and remorse
24
Q

What are 3 medications used in treating anorexia nervosa?

A
  • Fluoxatine (SSRI)
  • Amitriptyline (TCA)
  • Olanzapine (Antipsychotic)
25
Q

Onset of bulimia? When can precipitate this condition

A
  • Late adolescence/early adulthood (18-19)

* During/After dieting

26
Q

What form of therapy is used to treat Bulimia? What is the FDA approved pharmacological treatment?

A
  • Cognitive behavioral therapy

* Fluoxetine (SSRI)

27
Q

5 Physical Presentations of Bulimia?

A
  • Scars/Calluses on hands (Russel’s sign)
  • Swollen parotid glands/esophageal and dental erosion
  • Peripheral edema
  • Muscle weakness
  • irreversible growth stunting
28
Q

What labs will appear to be abnormal in Bulimia?

A
  • Abnormal Na/K values

* Decreased basal metabolic rate

29
Q

What are four Cardiac issues that can arise with Bulimia?

A
  • EKG changes (can be from muscle wasting)
  • Cardiomyopathy/Reduced contractility/output
  • Bradycardia <50 bpm
  • Orthostatic pressure changes
30
Q

To diagnose bulimia nervosa, how many episodes of binging and purging must the patient engage in?

A

*Once weekly for 3 months

31
Q

What substance should clients with bulimia avoid?

A

*Caffeine

32
Q

2 GI complications seen in Anor/Bul? How long does it take for Motility to return to normal with balanced diet?

A
  • Slow motility/constipation
  • Abdominal distention
  • 3 weeks
33
Q

3 skeletal complications seen in Anor/bulimia?

A
  • Failure to achieve height potential
  • Osteopenia/Osteoporosis
  • Higher risk for fractures due to decreased mineral density
34
Q

2 brain complications from anor/buli?

A
  • Cerebral atrophy w/ventricular enlargement

* Loss of gray/white matter

35
Q

Diets low in ____ and ____ can result in depletion of which neurotransmitters? What will this contribute to?

A
  • Tryptophan and tyrosine
  • Dopamine and serotonin
  • Depression/anxiety/attention deficits
36
Q

Weight below ____ of normal body weight requires hospitalization

A

*85%

37
Q

4 goals/ treatments in medically hospitalized eating disorder clients?

A
  • Cardiac stabalization
  • Electrolyte supplementation
  • NG feedings
  • Weight gain of 2 to 3 lbs per week (in anorexia)
38
Q

Appearance of bulimic client in regards to weight?

A

*Usually normal weight

39
Q

Outpatient medical management for people with eating disorders:

  • Outpatient weight gain goal of _____?
  • Resumption of ___? How long?
  • Appropriate amount of ____ an ____
  • Calcium supplementation of _____-____ divided into ___ doses per day.
  • How much Vitamin D?
  • How much Zinc?
A
  • 0.5-1 lb a week
  • Menses within 6 months (when at 90% ideal body weight)
  • Exercise and activity
  • 1200-1500mg of calcium divided into 3 doses per day
  • 400-1000IU per day of vitamin D
  • 30mg/ day of zinc
40
Q

3 types of therapy indicated for BED?

A

*Family, Cognitive behavioral, Psycho

41
Q

2 pharmacological treatments for BED?

A
  • lisdexamfetamine(Vyvanse)

* combo of buproprion/naltrexone (wellbutrin/vivitrol) (Contrave)

42
Q

When assessing history of anorexia clients usually display what kind of children?

A

*Model child/ in control

43
Q

When assessing history of bulimia clients usually display what kind of children?

A

*Eager to please/avoid conflict

44
Q

which reproductive hormones are affected in men and women with eating disorders?

A
  • Low testosterone in men

* Low FSH and LH in women (amenorrhea)

45
Q

Four outcomes for people with eating disorders?

A
  • Establish adequate nutritional eating patterns
  • Eliminate compensatory behaviors
  • Demonstrate positive coping mechanisms
  • Verbalize acceptance of body image w/ ideal body weight
46
Q

A coping strategy for a person w/ bulimia would be _____? Whats an example?

A
  • Self-monitoring

* Food diary

47
Q

People diagnosed with bulimia nervosa have lower levels of which neurotransmitter?

A

*serotonin

48
Q

Re-feeding resulting in a _____weight gain can overwhelm the _____, resulting in ______collapse.

A
  • Too-rapid
  • Heart
  • Cardiovascular

Nursing 232- Exam 2 (11 decks)

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