Eating disorders and Alzheimers

Question 1

ED’s are connected to the underlying emotions of?

Answer 1

Anxiety, low self-esteem, feelings of lack of control, dysphoria

Question 2

What might eating disorders be activated by?

Answer 2

Psychological low self-esteem and self-doubts, environmental control vs chaos, cultural factors and values on outward appearance.

Question 3

Eating disorders are what?

Answer 3

Cognitive distortions that are the result of processing errors in the brain. Determining which cognitive disorders were present before the ED and which ones are the result of semi-starvation is important but difficult

Question 4

What do ED’s arise from?

Answer 4

Complex conditions that arise from a combination of long-standing behavioral, biological, emotional, psychological, interpersonal, and social factors.

Question 5

ED’s are connected to the underlying emotions of?

Answer 5

Anxiety, low self-esteem, feelings of lack of control, dysphoria

Question 6

ED’s have a significant comorbidity with?

Answer 6

Mood and anxiety disorders, substance abuse, body dysmorphic disorders, impulse control disorders, personality disorders (esp borderline and OCD). Always assess psychiatric risk, including suicidal and self-harm thoughts, plans, or intent.

Question 7

Characterized by starvation and weight loss. Symptoms?

Answer 7

Anorexia. Inadequate food intake leading to a weight that is clearly too low. Intense fear of weight gain, obsession with weight and persistent behavior to prevent weight gain. Inability to appreciate the severity of the situation.

Question 8

Binge-eating/purging type involves what?

Restricting type does not involve what?

Answer 8

Binge eating and/or purging behaviors during the last three months
Restricting type does not involve binge-eating or purging

Question 9

What are the three main categories of neurocognitive disorders?

Answer 9

Delirium, dementia, and mild neurocognitive disorder

Question 10

Delirium is present in how many people?

Answer 10

60% of nursing home residents who are age 75 years or older. About 75-85% of people with a terminal illness develop delirium near death.

Question 11

Delirium always what?

Answer 11

Exists secondary to another medical condition or substance use. Cause include surgery, drugs, UTIs, pneumonia, cerebrovascular disease, and CHF.

Question 12

What are the four cardinal features of delirium?

Answer 12

Acute onset and fluctuating course, inattention, disturbance of consciousness, and disorganized thinking.

Question 13

Some assessments for delirium?

Answer 13

Fluctuating levels of consciousness. Interview the family to determine the pt’s normal level of consciousness and cognition. Medical findings and diagnostic data. Assess vitals and neuro. Risk for injury. Need for comfort measures. Availably of an immediate medical intervention to prevent brain damage.

Question 14

Communication guidelines for delirium?

Answer 14

Keep distractions to a minimum (one person speaks at a time). Always identify yourself. Speak slowly with short simple words and concrete info. One piece of info at at time. Familiar things. Reinforce reality. Eyeglasses and hearing aids. Reality-orientation tools.

Question 15

What implementations should be done with delirium?

Answer 15

Prevent physical harm caused by confusion, aggression, or fluid and electrolyte imbalance. Perform an assessment. Proper health management to eliminate underlying cause. Supportive measures to relieve stress. Support family members.

Question 16

Random facts about dementia?

Answer 16

Insidious (months or years). Chronic, progressive, irreversible. Ends in death. Alertness and orientation are normal but impaired as processes. Short term memory impaired. Unconcerned about memory deficits. Unable to reason, make judgments, prone to hallucinations. Repetitive, superficial, trouble finding words, confabulation.

Question 17

Etiology of Alzheimer’s disease?

Answer 17

Age. Biological factors (neurofibrillary tangle, senile plaques, cerebral atrophy). Genetic (diagnosis is made based on symptoms and ruling out all other possible disorders)

Question 18

Cognitive impairment in AD involved what four A’s?

Answer 18

Amnesia, aphasia, apraxia (loss of purposeful movement in the absence of motor or sensory impairment), agnosia (loss of sensory ability to recognize objects)

Question 19

Stage 1 of Alzheimer’s disease?

Answer 19

MILD. Forgetfulness. Difficulty with complex tasks. Awareness of confusion associated with anxiety and depression. May be disoriented to time, difficulty finding “right word”, denial.

Question 20

Stage 2 of Alzheimer’s disease?

Answer 20

MODERATE. Confusion. Zgaps in memory. Confabulation, wandering behavior and falls, apraxia, hyperorality, decline in personal appliance, needs assistance with ADL’s, mood lability, social withdrawal, overwhelmed with frustration. Driving becomes hazardous.

Question 21

Stage 3 of Alzheimer’s?

Answer 21

MODERATE TO SEVERE. Unable to identify familiar objects or people. Hyperoralirty with periodic binge eating. Hyperetamorphosis. Refusing ADL’s. Loss of language skills. Perseveration. Psychotic symptoms. Catastrophic reactions to everyday events.

Question 22

Stage 4 of Alzheimer’s?

Answer 22

LATE. End-stage. Unable to read, write, talk, or walk. Difficulty swallowing, emotionally blunted.