Eating Disorders Flashcards
Causes/Risk Factors: Genetics
Fx of bulimia nervosa, mood disorders, substance use disorders, or obesity
Risk factors for anorexia
Female adolescent
Risk factors for bulimia nervosa
2% among women in late adolescence or early adulthood
Psychological factors that cause eating disorders
Unfulfilled sense of separation
Threaten vulnerable ego, feeling of lack of control over one’s body
OCD: obsessed with food
Social influences that cause eating disorders
Peer pressure, ballet training/wrestling sports, media
Definition of anorexia nervosa
Morbid fear of obesity, weight loss is excessive, less than 85% of expected weight
Anorexia nervosa
Restricting type
During the last 3 months, the pt hasn’t had episodes of binge eating or purging
Anorexia Nervosa
Binge-eating/Purging type
During the last 3 months, pt engages in recurrent episodes of binge eating or purging behavior
Medical S&S of anorexia nervosa
hypothermia, bradycardia, orthostatic hypotension, peripheral edema, and lanugo, and a variety of metabolic changes, dizziness, pain and discomfort, constipation, weakness, amenorrhea
S&S of anorexia nervosa
Gross distortion of body image
Refusal to eat
Obsessed with food
Compulsive behaviors
Depression and anxiety
Diagnosis of Anorexia nervosa
Restriction of energy intake leading to significant low body weight
Intense fear of gaining weight/becoming fat
Lack of recognition of seriousness of current low body weight
Severity of Anorexia nervosa
Mild: BMI > 17
Moderate: BMI 16-16.99
Severe: BMI 15-15.99
Extreme: BMI < 15
Treatment of anorexia nervosa
Slowly give food in increments, minimize focus on food, pocketing food, individual and family psychotherapy
Nursing interventions for anorexia nervosa
Alternative feedings, monitor labs, minimize focus on food, monitor I&O, monitor weight, close supervision during and after meals, collaborate with dietary staff
What is refeeding syndrome?
medical complications that result from fluid and electrolyte shifts as a result of aggressive nutritional rehabilitation.
Definition of bulimia nervosa
Episodic, uncontrolled, rapid ingestion of large amounts of food over a short period, followed by inappropriate compensatory behaviors
Complications of bulimia nervosa
Heartburn, insomnia, depression and anxiety, dehydration, fluid electrolyte imbalances, gastric rupture
Comorbidity of bulimia nervosa
mood disorders, anxiety disorders, or substance abuse
CNS stimulants or alcohol
S&S of bulimia nervosa
Weight fluctuations
Excessive concern with personal appearance: how others perceive them
Excessive vomiting and laxative or diuretic abuse
Erosion of tooth enamel
Tears in the gastric or esophageal mucosa
Calluses on the dorsal surface of their hands (Russell’s sign)
Diagnosis of bulimia nervosa
Recurrent episodes of binge eating
Binge eating and inappropriate compensatory behaviors occur at least once a week for 3 months
Severity levels of bulimia nervosa
Mild An average of 1-3 episodes per week
Moderate: An average of 4-7 episodes per week
Severe: An average of 8-13 episodes per week
Extreme: An average of 14 or more episodes of per week
Treatment of bulimia nervosa
Triggers, mood and family therapy, dietitian, dietary requirements: well balanced diet, SSRI for depression, hospitalized
Nursing interventions for bulimia nervosa
supervised at meal time, set a time limit for eating, food journal, helping to relieve stress, patient and family education. Always include family in treatment
Definition of binge eating disorder
Episodes of binge eating with absence of compensatory purging = risk of substantial weight gain
Occur over a discrete period, less than 2 hours. Eating is out of control
Triggers of binge eating disorder
interpersonal stressors, low self-esteem, and boredom
Medical complications of binge eating disorder
diabetes, cardiac disease, hyperlipidemia, gallbladder disease, hypertension
S&S of binge eating disorder
Constantly thinking about food
Higher risk of substance abuse
Eating every 2 hours
Diagnosis of binge eating disorder
Eating in a discrete period of time
No use of inappropriate compensatory behaviors
Severity of binge eating
Mild: 1-3 binge-eating episodes per week
Moderate: 4-7 binge-eating episodes per week
Severe: 8-13 binge-eating episodes per week
Extreme: 14 or more binge-eating episodes per week
Treatment/Nursing intervention of binge eating
psychotherapy (what is the underlying causes), therapeutic relationship, food journaling, thyroid problems
Family and client education regarding eating disorders
Principles of nutrition
Ways pt may feel in control of life
Importance of expressing fears and feelings
Alternative coping strategies
Medication Education
Relaxation techniques
Problem solving-techniques
Maudsley approach
Special education for the obese patient
How to plan a reduced-calories, nutritious diet
How to read food content labels
How to establish a realistic weight lost plan
How to establish a planned program of physical activity
Maudsley approach
Phase 1: focused on weight restoration
Parents are actively engaged in establishing the rules and guidelines around eating
Move onto phase II when pt accepts parental demands for > food intake and demonstrates steady weight gain, and change in mood
Phase II: control of maintaining weight gain is returned to the adolescent
Move to phase III if able to maintain > 95% of ideal weight
Phase III: develop a health self-identity: incorporating CBT and DBT skills
