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Exam 4 > Eating disorders > Flashcards

Eating disorders Flashcards

1
Q

What are the 3 types of eating disorders?

A
  • -Anorexia Nervosa (AN)
  • -Bulimia Nervosa (BN)
  • -Binge Eating Disorder (BED)
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2
Q

Comorbidities to eating disorders may include..

A
  • -mood disorders
  • -substance abuse
  • -anxiety
  • -self injurious behavior
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3
Q

What are positive feedback signals initiated by?

A

Feeding behavior

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4
Q

In negative feedback signals, increased potency is required to…

A

terminate eating

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5
Q

What to hormones influence meal size and duration?

A
  • -Cholecystokinin (CKK)

- -Glucagon like peptide (GLP-1)

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6
Q

The biological theory relevant to eating disorders involves what factors?

A
  • -genetics
  • -neurotransmitter dysfunction
  • -Endorphins
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7
Q

What hormone is involved with neurotransmitter dysfunction? What happens when it is high or low?

A
  • -5-HT serotonin
  • -Low: increased food intake
  • -high: decreased food intake
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8
Q

What hormone increases food intake and elevates mood?

A

endorphins

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9
Q

What theory of an eating disorder involves learned patterns or irrational thoughts and beliefs? How can the patient be helped?

A
  • -Cognitive Behavioral Theory

- -changing maladaptive behavior and replacing it with healthier response.

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10
Q

what theory involves unconscious conflicts?

A

Psychoanalytic Theory

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11
Q

What is a biological risk factor in a person with an eating disorder?

A

Genetics

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12
Q

What are some sociocultural RF’s for a person with an eating disorder?

A
  • -female
  • -age (teens-20’s)
  • -dieting
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13
Q

What are some family RF when it comes to eating disorders?

A
  • -Family hx.
  • -enablers (not the cause)
  • -abuse (childhood/adolescent)
  • -interpersonal relationships (pressure form parents for need to succeed)
  • -difficulty with conflict resolution
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14
Q

What are 3 similar clinical manifestations between the three types of eating disorders?

A
  • -body image disturbance
  • -anxiety
  • -ineffective coping skills
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15
Q

what is a potentially life threatening eating disorder where the patient does not eat (or they will purge if they have to eat)?

A

Anorexia Nervosa (AN)

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16
Q

Anorexia is more common in…

It usually begins at what life stage (age group)

A
  • -females (academics, goals, rigid rules to control weight)

- -teen years

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17
Q

What are the clinical manifestations of anorexia nervosa?

A
  • -Intense fear of weight gain
  • -refuse to maintain healthy weight
  • -distorted body image
  • -self-induced vomiting (if they have to eat)
  • -body disturbances
  • -cut food in small pieces (pretend to eat)
  • -refuse to eat in front of others
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18
Q

What are common substances a person with anorexia may use to lose weight?

A
  • -laxatives
  • -diuretics
  • -diet pills
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19
Q

A person with anorexia may become malnourished. What signs would the nurse see if a patient is malnourished?

A
  • -brittle hair/nails
  • -dry, yellow skin
  • -lanugo
  • -always cold
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20
Q

Anorexia can cause damage to the brain, heart, and kidneys. What signs would the nurse see if this is to happen?

A
  • -low BP, HR

- -irregular heart rhythms (lead to heart failure)

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21
Q

Clinical therapies for a pt. with Anorexia are…

A
  • -Antidepressants (fluoxetine)
  • -antipsychotics
  • -mood stabilizers
  • -CBT
  • -Group, family therapy
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22
Q

What should the nurse advise the pt. of when taking fluoxetine?

A
  • -May take 1-3 weeks to take effect (2 months for max response)
  • -avoid operating heavy machinery (until individual side effects are known)
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23
Q

a person with anorexia may have a hard time getting pregnant due to low…

A

estrogen/testosterone levels

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24
Q

This conditions is described as binging on food or overeating then purging to avoid weight gain.

A

Bulimia Nervosa (BN)

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25
Q

Bulimics usually get rid of food by way of..

A
  • -vomiting (purging)
  • -laxatives
  • -enemas
  • -diuretics
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26
Q

What clinical manifestations would a bulimic person present?

A
  • -cycle of binging and purging food
  • -extreme exercise (compensate for binging)
  • -hoard food/large amounts of trash due to overeating
  • -secretive
  • -menstrual irregularities
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27
Q

Why is bulimia frequently undiagnosed?

A

Pt. has healthy weight or is obese

28
Q

The onset of bulimia usually occurs during…

A

late adolescence or early adulthood

29
Q

Purging is used for…

A
  • -purification rituals

- -regaining self control

30
Q

What is the treatment for a pt. with bulimia?

A
  • -Antidepressants (fluoxetine)
  • -CBT
  • -Family therapy
31
Q

What disorder describes periods of rapid overeating in a short amount of time with inability to stop?

A

Binge Eating Disorder (BED)

32
Q

what separates binge eating from the other two disorders?

A

Pt. does not purge

33
Q

during an episode of overeating the patient may feel…

A

out of control

34
Q

When a patient binge eats what are usual food choices?

A
  • -junk food

- -fast food

35
Q

When does a persons binge eating end?

A
  • -when abd. pain becomes severe
  • -get interrupted
  • -run out of food
36
Q

what are some clinical manifestations of binge eating?

A
  • -loss of control

- -embarrassment, disgust after eating

37
Q

Binge eating can be treated with…

A
  • -antidepressant (fluoxetine)

- -CBT

38
Q

What are some diagnostic tests that can be done on a patient with anorexia?

A
  • -Albumin, total protein (hypoalbuminemia)
  • -electrolytes (risk hypokalemia)
  • -ABG’s
  • -CBC (anemia, leukopenia, thrombocytopenia)
  • -Bone density (reduced)- risk osteoporosis
  • -ECG (prolonged QT interval)
  • -Urinalysis (kidney fx.)
  • -Kidney, thyroid, liver fx. tests (BUN increased)- dehydration
39
Q

What are some diagnostic procedures for bulimia?

A
  • -Dental assessment

- -Physical exam

40
Q

During a dental assessment for bulimia what will the nurse look for?

A
  • -cavities
  • -gum infection
  • -enamel worn (vomiting)
41
Q

During the physical exam what will the nurse look for?

A
  • -eyes (broken blood vessels)
  • -dry mouth
  • -fat cheeks
  • -rash/pimples
  • -cut/calluses on finger joints
42
Q

Diagnostic tests for binge eating include..

A
  • -Physical exam
  • -blood tests
  • -urine test
43
Q

A patient that has anorexia or bulimia is at risk for what acid base imbalance due to excessive vomiting?

A

metabolic alkalosis

44
Q

A patient that has anorexia or bulimia is at risk for what acid base imbalance due to laxative use?

A

Metabolic acidosis

45
Q

What are some non-pharm approaches with anorexia?

A
  • -Psychotherapy

- -Maudsley approach

46
Q

What is the Maudsley approach? Who does it help?

A

helps with adolescents, the parent takes over feeding the pt.

47
Q

What non pharm therapy is effective with Bulimia, and binge eating?

A

CBT

48
Q

How does CBT help with a patient who has an eating disorder?

A

Focuses on the problem and how to solve it

49
Q

What outpatient treatment is the 1st line approach to an eating disorder?

A

Long term outpatient tx.

50
Q

In patient therapy is used for…

A

severe cases

51
Q

What does inpatient services provide for the patient?

A

structured, contained environment

52
Q

What are some other therapies that can help with eating disorders?

A
  • -chamomile tea
  • -acupuncture
  • -massage
  • -yoga
  • -biofeedback
53
Q

When assessing a patient the nurse should not assume the patient has an eating disorder… What should be done before dx. a pt. with eating disorder?

A

other possible causes

54
Q

What will the nurse see during a physical assessment of a client with anorexia?

A
  • -emaciated
  • -skin dry, have lanugo, yellow in color
  • -brittle hair and nails
  • -Bradycardia
  • -hypotension
  • -cardiac dysrhythmias
55
Q

What will the nurse see during a physical exam of a client with bulimia?

A
  • -cavities
  • -tooth erosion
  • -hoarse voice
  • -dehydrated
56
Q

What are some signs a patient may be dehydrated?

A
  • -hypotension
  • -dry mouth
  • -poor skin turgor
  • -dizziness
  • -weakness
  • -reduced UOP
  • -concentrated urine
57
Q

What are 3 nursing Dx. for a patient with an eating disorder?

A
  • -Risk for injury
  • -Deficient fluid volume
  • -Imbalanced nutrition
58
Q

What are some priority interventions when caring for a pt. with an eating disorder?

A
  • -Protect client from physiological effects
  • -Safety (prevent injury)
  • -identify/treat cause of behavior issues
59
Q

the nurse should encourage healthy ____ and _______.

A
  • -healthy behaviors

- -thought patterns

60
Q

what type of relationship should the nurse promote with the pt?

A

Therapeutic

61
Q

Talking about the disorder may be sensitive and painful to clients but, tx. requires….

A

–openness

62
Q

Transition requires patient courage, trust must be established. What are 3 other things that should be established between all parties?

A
  • -Respect
  • -consistency
  • -patience
63
Q

The nurse must remember patient preferences when creating the treatment plan, What should the nurse include in the plan?

A
  • -Provide structured and inflexible eating schedule
  • -give small frequent meals
  • -provide high fiber, low sodium diet
  • -limit fatty/gassy foods at start of tx.
  • -Administer multivitamins and mineral supplements
  • -avoid caffeine
64
Q

This potentially fatal syndrome is a complication of eating disorders, it occurs when fluids, electrolytes, and carbs are introduced to a severely malnourished pt. and there is a sudden shift in electrolyte and fluid balance.

A

–Refeeding syndrome

65
Q

what are nursing actions pertaining to Refeeding syndrome?

A
  • -care for client in hospital;l setting
  • -consult with provider and dietician on controlled nutritional support
  • -monitor electrolytes
66
Q

Another complication linked to eating disorders is…

A
  • -cardiac dysrhythmias
  • -severe bradycardia
  • -hypotension
67
Q

If a patient has complications pertaining to dysrhythmias, low BP, and HR what should the nursing action be?

A
  • -place client on continuous cardiac monitoring
  • -Monitor VS
  • -Report changes to provider

Exam 4 (10 decks)

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