Eating disorders

Question 1

What is anorexia nervosa?

Answer 1

Body image distortion occurs when person perceives their body different than how society views it. They have a drive for thinness that overrides other physiological body cues and have a fear of becoming fat.

Question 2

What is interoceptive awareness?

Answer 2

Term used to describe sensory response to emotional/visceral cues like hunger

Question 3

Epidemiology in AN?

Answer 3

Occurs accross lifespan, increase risk among 1st degree relatives, onset in adolescence/early adulthood, associated with stressful transition, occurs mostly in women, comorbid with mood/anxiety disorders, age of onset 14-16 yrs, culturally defined weight expectation

Question 4

What is social comparison?

Answer 4

Evaluate oneself against idealized others like models

Question 5

What is body dissatification?

Answer 5

Belief that one’s body differs from ideal body size and causes negative appraisal (I feel fat). It can lead to purging, binge eating, dieting, and low self esteem.

Question 6

Biological, spiritual, social, and psychological risk factors for AN?

Answer 6

B- dieting, altered metabolic rate, hx of overweight, over exercising
S- need for greater purpose
P- low self esteem, body dissatisfaction, sexual abuse, feelings of ineffectiveness
Social- media, fashion industry, focus on ideal body type, peer pressure, family attitudes, cultural

Question 7

Treatment goals for AN?

Answer 7

Initiate nutritional rehab, increase effective coping, resolve conflict around body image, meds if necessary, and address underlying conflict.

Question 8

Biological domain- assess, dx, interventions

Answer 8

A- evaluate systems, hx with patient/family, determine weight with BMI, menses hx, sleep pattern
D- inadequate nutritional status, sleep disturbance, less than body requirements
I- refeeding, monitor/record intakes, sleep hygiene, weight increasing protocols, exercise not permitted

Question 9

Psychological domain- assess, dx, interventions

Answer 9

A- low weight, eating attitude test, unrealistic expectations/thinking, ritualistic behaviours
D- anxiety, disturbed body image
I- normalize shame experience, encourage journaling, indemnify/understand feelings, imagery/relaxation, psychotherapy, restructure cognitive distortions

Question 10

Social- assessment, dx, interventions

Answer 10

A- school attendance, family interaction
Dx- social isolation, infective coping
I- facilitate transition to school, family therapy, family education

Question 11

Spiritual domain?

Answer 11

Need to move forward (establish trust, rapport, consistency). Support client while enabling them to voice and make meaning of their eating disorder

Question 12

What is bulimia nervosa?

Answer 12

Episodes of binge eating with lack of control, then self induced vomiting/use of laxative/enemas/diuretics/fasting/strict diets/excessive exercising after eating. They are preoccupied with weight/body shape/self perceived flaws.

Question 13

BN cycle?

Answer 13

Hunger - binge eat - shame/humiliation - diet/purge via vomiting etc.

Question 14

What is dietary restraint?

Answer 14

Effort to restrict food intake for weight loss/prevent weight gain. This was originally described to explain difference between eating patterns of obese people and those of a healthy weight

Question 15

Epidemiology of BN?

Answer 15

More prevalent in men, r/t western culture social values, onset in adolescence/early adulthood (older than AN), comorbid disorders (substance use, depression, anxiety), 1st degree relative who had it=more likely to developed it

Question 16

Nursing management for BN?

Answer 16

Focus on inadequate nutrition, malnourishment, anxiety, inability to exercise personal control, difficulties managing social expectation. They feel shame/guilt and have intense need to please others and be liked.

Question 17

Biological- A, D, I

Answer 17

A- similar to AN, binging/purging behaviour
D- poor nutritional status, sleep disturbances
I- pharmalogic, nutrtion counselling

Question 18

Psychological domain BN?

Answer 18

Assess cognitive distortions and body dissatisfaction. Interventions- CBT in group/self help, behavioural techniques

Question 19

True or false: those with BN are less likely to require hospitalization

Answer 19

True

Question 20

Psychosocial domain BN?

Answer 20

Psychoeducation, understand binge/purge cycle, misuse of laxative/diuretics. Assess family, group therapy,

Question 21

Spiritual domain BN?

Answer 21

Assess expression of loss/powerlessness, self care capacity, quality of relationships, self judgements, hx of traumatic experiences, attitudes about food.
I- encourage to express feelings, journal writing, meditation, imagery, affirming positive self worth

Question 22

What is binge eating disorder (BED)?

Answer 22

Ingestion of large amount of food in short period of time. They have loss of control during binge and eat until uncomfortably full. No purging involved. Feelings of guilt/depression following binge. BED associated with someone who’s overweight. They have lower dietary restraint. May miss social activities/work to binge eat.

Question 23

Epidemiology of BED?

Answer 23

Beings in late adolescence and early adulthood, more prevalent in females, western culture influence, may run in families, outpatient care setting. Comorbid medical conditions are diabetes, HTN, pain conditions, and sleep problems. Comorbid disorders are substance use/mood.

Question 24

Goals of treatment for BED?

Answer 24

Reduce binge eating, maintain weight loss, restructure dysfunctional thinking, alleviate comorbid depression anxiety, and address harassment.

Question 25

Nursing focus of management for BED?

Answer 25

Excessive calorie intake, decreased energy, inability to engage in personal care amities/sustain actions to meet health needs, difficulty managing social expectation.

Question 26

Biological domain BED?

Answer 26

Assess- binge eating patterns, symptoms of gastric distress, physical mobilty, activity, sleep pattern
Dx- altered nutrition, risk for overweight BMI, altered mobility, activity intolerance
I- food diary, pharmacological

Question 27

Psychosocial domain BED?

Answer 27

A- cognitive distortions, knowledge deficits, dissociation
Dx- anxiety, knowledge deficit, connection with other/society
I- CBT, family support, psychoeducation

Question 28

Spiritual domain BED?

Answer 28

A- self judgement/self acceptance, enable client to describe painful traumatic experiences
Dx- dissatisfaction with life, loss of self identity, loss of self worth
I- counselling, support

Question 29

True or false: BED may have more favourable remission rate than other eating disorders

Answer 29

True

Question 30

Criteria for AN?

Answer 30

Have significantly low body weight, intense fear of gaining weight/becoming fat, disturbance in the way one’s body and weight is experienced.

Question 31

2 types of AN?

Answer 31

1. Restricting
2. Binge purge