Eating disorders Flashcards by Rhea Donna Bagasin

more than just about food. It is a type of
mental illness that involves unhealthy thoughts and behavior
towards food, weight, and body shape

eating disorders

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Ingestion of non-nutritive and non-edible
substances

pica

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Repeated regurgitation and rechewing of food

ruminating

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It is the failure to eat adequately

feeding disorder

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Eating of unusual large amount of food in a
relatively short period of time

binge

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To eliminate food by inducing vomiting,
enema, laxative, and diuretics

purge

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A person made excessively thin by the lack of
nutrition

emaciated

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disorder characterized by binge eating, over
concerned with body shape and weight

bulimia

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A disorder characterized by restrictive eating
resulting in emaciation, disturbance in body
image and intense fear of becoming obese

anorexia

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It is the consumption of more calories than
what the body needs.

obesity

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A person with a mother or sister who has had
anorexia nervosa are likely to develop the
disorder

biological factor

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A person with eating disorder tends to be
perfectionist, with unrealistic expectation of
themselves and others

psychological factor

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Some person with eating disorder belongs to
overprotective family

family factor

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A person who are into relationship that they
need to be thin to be continually accepted

social factor

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In westernized country where female are
pressured to be thin to be accepted

cultural pressures

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People who are happy and successful are
almost always portrayed by actors or models
who are young, thin, and toned

media factors

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People who are socialites, dancers, models,
gymnast, actress, entertainers, and male
homosexuals

lifestyle

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Person who usually survived tends to have
eating disorders

physically and sexually abused

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Nursing Diagnosis

o Alteration in health maintenance
o Altered nutrition: less than body requirement
o Altered nutrition: more than body requirement
o Anxiety
o Body image disturbances
o Ineffective family coping: compromised
o Ineffective individual coping
o Self-esteem disturbances

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The relentless pursuit of thinness or weight phobia
o Refusal to eat, relentless pursuit to thinness, weight
phobia

Anorexia Nervosa

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Defense mechanism for Anorexia Nervosa

Denial

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One of the causes of anorexia nervosa is mood (appetite mo)

serotonin

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Causes of anorexia nervosa: pinipilit ni mother ang gusto niya

dominant mother

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causes of anorexia nervosa: sexual drive
(mababa), naapektuhan din appetite at hormones

disturbances in the hypothalamus

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10 Characteristics of Anorexia Nervosa

a. Obsessive b. Underweight c. Adolescent d. Introvert/ low self-esteem e. Denies disorder f. Deceitful vomiting, enema, diuretics, laxatives g. Perfectionist h. Suicidal, sleep 2-3 hours i. People pleaser – acceptance ng mga nasa paligid j. Dichotomous thinking – iba yung iniisip mo sa tingin mo (mirror = payat ka – tingin mo mataba ka)

Behavior (AN): often affected

Adolescent and youngest female child

how many percent die and half of them are suicidal in AN?

10-20%

They eat in social functioning but purge themselves. But avoids social functions gradually.

Anorexia Nervosa

As a child, they are chubby or overweight

Anorexia Nervosa

o A perfect girl, ideal, conscientious, hardworking and people pleasers

Anorexia Nervosa

o Depending to family o Focus in losing weight o Depress, irritable, withdraws and decrease libido

Anorexia Nervosa

As disorder progresses they become deceitful, stubborn, hostile and manipulative

Anorexia Nervosa

8 effects of Anorexia Nervosa

a. Emaciated b. Constipation c. Decrease libido d. Dry skin/falling hair e. Amenorrhea f. Electrolyte imbalances (mababa yung K = Cardiac Arrest) g. Susceptible to infection h. Death due to cardiac arrest

what to do first before medication to patients with anorexia nervosa?

Correct electrolytes

11 nursing care for patients with Anorexia Nervosa

1. Convey warmth and sincerity (trust) 2. Monitor I and O (purge) 3. Listen (afraid to show emotions) 4. Be honest (distrustful) 5. Set limits (manipulative) 6. Teach patient about the disorder (denial) 7. Avoid long silence (rejection) 8. Be consistent (trust) 9. Daily weight taking (not facing the scale) 10. Involve family in treatment process (sila yung dahilan) 11. Positive reinforcement (weight gained)

12 nursing management for Anorexia Nervosa

1. Use reinforcement to help patient gain weight 2. Acceptance and nonjudgmental 3. Listen to the patient 4. Be honest 5. Avoid long silence 6. Close observation 7. Weigh patient not facing the weighing scale 8. Set limits 9. Let them participate in their planning process 10. Teach them about their illness 11. Be consistent 12. Involve family in the treatment

How to establish eating pattern to patients with anorexia nervosa

1. Sit with the patient during meals and snack time  May possibility sila maghoard  Magstay ka kahit gano katagal  Kung lalabas siya or iihi, sabihin mo na before meals (kasi baka isuka or itapon) 2. Offer CHON and CHO food patient prefers 3. Adhere to the treatment program 4. Observe patient after meals or snacks 5. Be aware to hide or discard food

for anorexia nervosa, first na binibigay kasi lower yung adverse effects

SSRI

what medication after electrolyte imbalance is corrected for patients with anorexia nervosa?

Antidepressants

Nursing care for the medications for patients with anorexia nervosa

a. First is to correct electrolyte imbalances b. Then give antidepressant (SSRI or mood elevators

3 antidepressants for anorexia nervosa

Prozac, zoloft, paxil

full effect of antidepressants for patients with anorexia nervosa

2-4 weeks

wash out period for anorexia nervosa

2 weeks

4 medication Side effects for anorexia nervosa

1. Nausea (administer with meals) 2. Diarrhea (low dosage/hydration) 3. Insomnia (adjust time of intake – morning) 4. Dry mouth (water candy)

AN: toxic (kapag super lala = TCA agad onsetad of SSRI or pag readmitted)

TCA

AN: Fatal

MAO

AN: = ↑ serotogenic effect  Naban to before = sife effect = stiffening, yellowish sclera

Lithium

AN: what to give to contradict EPS?

Anti parkinsons

AN: Drug interaction

Antipsychotic - ↑ EPS – Extra Pyramidal Side Effects (AIMS – abnormal involuntary movement scale)

AN: pregnant; cleft palate

low dosage; high dosage

 Spasms in discrete muscle groups, such as the neck muscles (torticollis) or eye muscles (oculogyric crisis)  May also be accompanied by protrusion of the tongue, dysphagia, and laryngeal and pharyngeal spasms

EPS: ACUTE DYSTONIC REACTIONS

EPS (AN): Acute dystonic reactions medications

 Diphenhydramine (Benadryl) – IM or IV  Benztropine (Cogentin) – IM

 Restless movement, pacing, inability to remain still, and the client’s report of inner restlessness  Usually develops when the antipsychotic is started or when the dose is increased

EPS: AKATHISIA

EPS (AN): medications for AKATHISIA

Beta-blockers such as propranolol (most effective), and benzodiazepines

 Includes shuffling gait, masklike facies, muscle stiffness (continuous), or cogwheeling rigidity (ratchet-like movements of joints), drooling and akinesia (slowness and difficulty initiating movement) -Increase dosage of an antipsychotic medication: Benzotropine (Cogentin), Trihexyphenidyl (Artane), Biperiden (Akineton)., Procyclidine (Kemadrin), Amantadine (Symmetrel), Diphenhydramine (Benadryl), Dizepam (Valium), Lorazepam (Ativan), and Propranolol (Inderal)

EPS: Pseudo parkinsonism, or neuroleptic-induced parkinsonism

are reversible movement disorders induced by neuroleptic medication

EPS

 Used to screen for symptoms of movement disorders  Observed in several positions, and the severity is rated from 0 to 4  Can be administered 3 to 6 months

AIMS

3 Therapies for AN

o Family therapy (kasi sila ang cause) o Individual therapy (hindi sila makaverbalize = denial) o Group therapy (include healed – give tips and encouragement)

o The diet-binge-purge disorder o Eating large amount of food in a short period of time o Binge-purge eating disorder

BULIMIA NERVOSA

Causes of Bulimia Nervosa

o Increased serotonin o Lack of care from the family (rebelling from family

characteristics for Bulimia Nervosa

o Obsessive compulsive o Normal or overweight o Late adolescent, early adulthood o Extrovert/ low self-esteem o Aware of the disorder and ashamed o Uncontrolled impulses o Hoarding

calluses on knuckles or back of hand due to repetitive self-induced vomiting over a long period of time

BN: Russel’s Sign

8000 cal in 2 hours or 50 000 cal in a day

Bulimia Nervosa

6 Effects of Bulimia Nervosa

o Detal problem o Vomiting o Use and abuse of laxatives, pills, and diuretics o ↑ peristalsis o Rectal bleeding o Constipation

4 Nursing care for bulimia nervosa

1. Accept patient as a worthwhile person 2. Encourage patient to discuss positive qualities about themselves 3. Inform patient to approach nurse when they feel the urge to binge 4. Encourage group activity *Patient with this kind of disorder is willing to be treated so they cooperate

Medications for Bulimia Nervosa

1. Antidepressant (SSRI) mood elevators – Tofraile or Prozac Note: 2-4 weeks full effect

Therapies for Bulimia Nervosa

o Family Therapy o Behavioral Therapy

APPEARANCE: Decrease normal weight or underweight

Anorexia Nervosa

APPEARANCE: Normal weight or overweight

Bulimia nervosa

AGE: 14-8 years old, they are younger

ANOREXIA NERVOSA

AGE: 15-25 years old, they are older

BULIMIA NERVOSA

FAMILY: Rigid/controlled

ANOREXIA NERVOSA

FAMILY: More conflicts, violent

BULIMIA NERVOSA

CHARACTER: Introvert/isolates

ANOREXIA NERVOSA

CHARACTER: Extrovert/sexually active/on drugs/stealing

BULIMA NERVOSA

AWARENESS: Denies

ANOREXIA NERVOSA

AWARENESS: Aware of the disorder

BULIMIA NERVOSA

SIDE EFFECTS OF STABILIZATION: - Abdominal discomfort - Edema - Constipation - Food - Swelling of Fingers

ANOREXIA NERVOSA

SIDE EFFECTS OF STABILIZATION: - Feels bloated - Immediate weight gain - Craving for particular - Diarrhea - Digestive distress

BULIMIA NERVOSA

ETIOLOGY FOR OBESITY

1. Lack of adequate variety of food to eat 2. Side effects of steroids 3. Compulsive eating

TYPES OF OBESITY: obese since childhood

DEVELOPMENTAL

TYPE OF OBESITY: maladaptive, occur later, used as coping styles when in stress

REACTIVE

5 Nursing Management for OBESITY

1. Assess suicidal thoughts 2. Assess depression 3. Provide one on one session 4. Provide activity 5. Provide group activity

Behavior occurs between 2-3 years and at least one month

PICA

possible causes for PICA

Mentally retarded, neglect, poor family supervision

Obsessed with exercise and engaged in it beyond the requirement for good health

ANOREXIA ATHLETICA

o Bigorexia o A disorder opposite anorexia o Client worry excessively that they are too small, undeveloped and frail muscles

MUSCLE DYSMORPHIA

A pathological fixation on eating “proper, pure or superior” food

ORTHOREXIA NERVOSA

Lack of appetite for breakfast because client is preoccupied eating late in the day or night

night eating syndrome

A client who eats while asleep

Nocturnal Sleep-related

A client eats, swallows and regurgitates food back into the mouth, chewed and swallowed

Ruminating Syndrome

An obsession with fine food including its purchase, preparation, presentation and consumption

GOURMAND SYNDROME

A congenital problem usually associated with mentally retarded which includes incessant eating

PRADER-WILLI SYNDROME