Eating Disorders

Question 1

Refeeding Syndrome

Answer 1

Body mass index <16
Significant weight loss, >10% in the past 3-6 months
Little or no nutritional intake in the last 5 or more days
Low levels of potassium, phosphate, or magnesium before feeding
History of alcohol or substance misuse
Long-term use of antacids or diuretics

Question 2

Anorexia nervosa

Answer 2

Intense fear of weight gain
Distorted body image
Restricted calories with significantly low BMI

Question 3

Anorexia nervosa Subtypes

Answer 3

Restricting
The individual drastically restricts food intake and does not binge or purge.

Binge-eating/purging type
The individual engages in binge eating or purging behaviors.

Question 4

Bulimia nervosa

Answer 4

Often weight within normal range or higher (BMI 18.5-30)
Recurrent episodes of uncontrollable binging
Inappropriate compensatory behaviors: vomiting, laxatives, diuretics, enemas or exercise
Self-image largely influenced by body image
Purging and non purging type

Question 5

Binge eating disorder

Answer 5

Recurrent episodes of uncontrollable binging without compensatory behaviors
Binging episodes induce guilt, depression, embarrassment, or disgust

Question 6

Behaviors

Answer 6

Peculiar handling of food: cutting food into small bits, eating very slowly, chewing each bite excessively, pushing pieces of food around plate, hiding food, fear of eating in front of others, obsessive diet habits (veganism, no sugar, no carbs, etc.)
Disappearing after means
Frequently looking in mirrors and checking appearance
Low self-esteem, self-worth, impulsivity, difficulty in relationships
Possible development of rigorous exercise regimen
Possible self-induced vomiting, use of laxatives and diuretics
Guilt or shame from eating

Question 7

Nursing Interventions

Answer 7

Self-assessment
Promote self-esteem and positive self-image; encourage decision making and sense of control
Cognitive-behavioral therapies
Cognitive reframing
Relaxation techniques
Journal writing
Desensitization exercises
Structured, inflexible meal and snack times
Small, frequent meals
High fiber, low sodium, limit high-fat, gassy foods and caffeine
Monitoring during meals and postprandial
Weight, labs, vitals
Multivitamins

Question 8

Overgeneralizations

Answer 8

“Other people don’t like me because I’m fat”

Question 9

All-or-Nothing Thinking

Answer 9

“If I eat any dessert, I’ll gain 50 lbs”

Question 10

Russell’s Sign

Answer 10

Self-induced vomiting

Calluses or scars on hand

Question 11

Lanugo

Answer 11

Anorexia Nervosa

Downy hair on the face and back

Question 12

Parotid Glands

Answer 12

Purging behaviors

Enlargement of parotid glands

Question 13

Dental erosion and Caries

Answer 13

Purging

Question 14

Amenorrhea

Answer 14

Anorexia Nervosa

Question 15

Esophageal Tears

Answer 15

Bulimia