Eating disorders

Question 1

3 types of eating disorders

Answer 1

anorexia nervosa
bulimia nervosa
binge eating disorder

Question 2

Restriction of energy intake to requirements, resulting in significantly low body weight
Intense fear of gaining weight, becoming fat, persistent fears
Gross distortion of body image, persistent lack of recognition of seriousness of low body weight

Answer 2

anorexia nervosa

Question 3

anorexia diagnostic criteria

Answer 3

-restriction of energy intake
- intense fear of gaining weight
-persistent behavior that interferes with weight gain
- Disturbance in the way in which one’s bodyweight or shape is experienced

Question 4

when does anorexia commonly begin?

Answer 4

adolescence or young adulthood

Question 5

often associated with a stressful life event (Ex. leaving home for college)

Answer 5

anorexia nervosa

Question 6

social factors related to anorexia

Answer 6

-family issues
- vocational influences (ballet, athletes, models)
- internet influences

Question 7

behaviors of anorexia nervosa

Answer 7

• intense fear of gaining weight
• refuse to eat w/ family or in public
  -may wear baggy clothing
  -laxative/diuretic abuse
  -overexercising
  -diet with restrictive carb/fat

Question 8

S&S of anorexia

Answer 8

• BMI 17 or below
• hypotension
• ekg changes
  -bradycardia
  -constipation
  -dehydration
  -no periods
  everything goes down

Question 9

Assessment for anorexia

Answer 9

-BMI
-Vital signs
- labs: CBC, lipids, LFT’s
- ECG
-bone density
-dental caries
-suicide assessment

Question 10

Anorexia lab findings: Hematology

Answer 10

-anemia

Question 11

Anorexia lab findings: serum chemistry

Answer 11

-hypercholesterolemia
-elevated hepatic enzymes
- hypomagnesemia, hypokalemia

Question 12

Anorexia lab findings: endocrine

Answer 12

• low T3 and T4
• low estrogen or testosterone

Question 13

nursing care for pt with anorexia

Answer 13

• monitor intake and output
• daily weights
  -stay with pt during meals
• avoid arguing and bargaining

Question 14

nursing diagnosis for anorexia

Answer 14

-risk for suicide
- imbalanced nutrition
- deficient fluid volume
-disturbed body image

Question 15

-recurrent episodes of eating unusually large amounts of food and feeling a lack of control over these episodes
-followed by behaviors that compensate for the overeating, such as forced vomiting, excessive use of laxatives or diuretics, fasting, excessive exercise, or a combination of these behaviors.

Answer 15

bulimia nervosa

Question 16

Unlike those with anorexia nervosa, people with bulimia nervosa may

Answer 16

maintain a normal weight or be overweight.

Question 17

bulimia diagnostic criteria

Answer 17

-Recurrent compensatory behaviors in order to prevent weight gain i.e., self-induced vomiting, laxative misuse, diuretics, fasting, excessive exercise
- Recurrent episodes of binge-eating, characterized by:
Eating in a discrete period of time i.e., any 2 hour period, an amount of food that is larger than what another person would eat in same time period
A sense of lack of control over eating during the episode

Question 18

-Begins during or after an episode of dieting
-Multiple stressful life events
-Elevated risk for mortality
-Elevated suicide risk

Answer 18

bulimia

Question 19

labs for bulimia nervosa

Answer 19

-CMP for electrolyte imbalance
- glucose
-TSH
-CBC
-amylase

Question 20

serious medical complications: Cardiovascular abnormalities (cardiomyopathy, EKG changes)
Electrolyte imbalances CAN LEAD TO DEATH
Hypokalemia, hyponatremia (purging, vomiting, laxative & diuretic use)
Ipecac intoxication can lead to cardiac failure
Esophageal varices (r/t vomiting)
Gastric rupture

Answer 20

bulimia

Question 21

People with _______ disorder lose control over their eating.

Unlike bulimia nervosa, periods of _______ are not followed by purging, excessive exercise, or fasting. As a result, people with ______ disorder are often overweight or obese

Answer 21

binge eating disorder

Question 22

most common eating disorder

Answer 22

binge eating disorder

Question 23

diagnostic criteria: Recurrent episodes of ________ characterized by:
Eating with a discrete period of time an amount of food that is much larger than what would be consumed by most people in the same time period

A sense of lack of control over eating during the episode

Answer 23

binge eating disorder

Question 24

Binge eating episodes are associated with 3 or more

Answer 24

-Eating more rapidly than normal
-Eating until uncomfortably full
-Eating large amounts of food when not hungry
-Eating alone because of embarrassment by amount of food
-Feeling disgusted with oneself, depressed, or guilty afterwards

Question 25

how often does binge eating occur on average

Answer 25

at least once per week for 3 months

Question 26

treatment of eating disorders

Answer 26

• ** restoration of patients nutritional status**
• medical stabilization
• psychotherapy
  -pharmacotherapy

Question 27

parmacotherapy for eating disorders

Answer 27

SSRI’s

Question 28

anorexia admission criteria: body weight percentage

Answer 28

less than 75 ideal body weight, or ongoing weight loss despite intensive management

Question 29

hospital admission criteria for anorexia

Answer 29

-Refusal to eat
-Body fat less than 10%
-Heart rate less than 50 bpm; 45 at bedtime
-Systolic pressure less than 90
-Orthostatic changes in-pulse increase over 20 bpm or BP decrease under 20
-Temp under 96
-Arrhythmia

Question 30

hospital admission criteria for bulimia

Answer 30

-Syncope
-Serum potassium concentration <3.2
-Serum chloride concentration <88
-Esophageal tears
-Cardiac arrhythmias including prolonged QTc
-Hypothermia
-Suicide Risk
-Intractable vomiting
-Hematemesis
-Failure to respond to outpatient treatment

Question 32

nursing diagnoses for eating disorders

Answer 32

-Imbalanced nutrition: less/more than body requirements
-Disturbed body image
-Deficient fluid volume
-Ineffective denial
-Anxiety