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mental health/psych > eating disorders (ch 18) > Flashcards

eating disorders (ch 18) Flashcards

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1
Q

bmi for obesity

A

30+

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2
Q

comorbidities with eating disorders

A
  • MDD
  • BPD
  • OCD
  • substance abuse
  • personality disorders
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3
Q

biological predisposing factors for eating disorder

A
  • hypothalamus dysregulation
  • reduced serotonin
  • decreased dopamine (binge eating)
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4
Q

typical psychological profile for pt with eating disorder

A
  • desire to control
  • perfectionist
  • avoids risk
  • people pleasers
  • alexithymia (inability to verbalize psychic experiences)
  • harm avoidance
  • high persistence
  • feelings of shame
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5
Q

inability to verbalize psychic experiences

A

alexithymia

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6
Q

DSM 5 anorexia nervosa (UNDER-exia)

A 
Underweight
Nervous to gain weight
Distorted perception
Exercise, purging
Restricting intake
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7
Q

physical S+S anorexia nervosa and bulimia nervosa

A
  • bradycardia, hypoTN
  • arrhythmia
  • hypokalemia, hypocalcemia
  • dehydration
  • amenorrhea
  • anemia, leukopenia
  • hypoglycemia
  • hypothermia
  • dry skin, hair loss
  • osteoporosis
  • constipation
  • edema

BULIMIA: +dental caries, esophagitis

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8
Q

DSM 5 bulimia nervosa (BOWL-emia)

A

Binging
Offsetting (purging)
Weekly for 3+ months
Linked to self esteem

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9
Q

indications for hospitalization for eating disorder

A
  • rapid weight loss (15+ lbs in 4 weeks)
  • weight below 70-75% ideal body weight
  • less than 10% body fat
  • hypokalemia (<2.5) from vomiting/laxative/diuretic use
  • severe bradycardia (<50 bpm)
  • Sbp <90
  • temp less than 96
  • cardiac arrhythmias
  • GI bleeding/dehydration
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10
Q

nursing care for pt in ED for eating disorder

A
  • set limits
  • create trust
  • help to identify feelings
  • help to increase self esteem
  • teach pt and family about eating disorder
  • address the control
  • teach healthy living
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11
Q

rules for eating on inpatient unit (5)

A
  • begin with 1500 cal/day
  • increase by 100 cal/day
  • watch pt for 1.5 hrs after meal
  • time limit for eating
  • remaining intake given through supplement
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12
Q

complications of hypophosphatemia caused by refeeding syndrome (3)

A

heart failure
arrhythmias
resp failure

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13
Q

syndrome: body in state of starvation, uses electrolytes as source of energy instead of food

A

refeeding syndrome

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14
Q

indications for psych hospitalization for eating disorder (4)

A
  • severely depressed/suicidal
  • resistant to outpt treatment
  • severely dysfunctional environment
  • lack of local outpt tx facility
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15
Q

med for anorexia to prevent relapse

A

fluoxetine

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16
Q

med for bulimia for acute and maintenance tx

A

fluoxetine

17
Q

med for bulimia to decrease binging and vomiting

A

TCAs

18
Q

DSM 5 body dysmorphic disorder (Fix ME DOC)

A

Fixation on flaw

Medical care seeking
Ego-systonic

Disabling
Obsessive thoughts
Compulsive behaviors

19
Q

DSM 5 binge eating

A
  1. recurrent episodes binge eating
    - large amounts food
    - feeling sense of being out of control
  2. 3 or more:
    - eating more rapidly
    - eating until uncomfortably full
    - eating large amounts when not hungry
    - eating alone or feeling embarrassed
    - feeling disgusted/guilty
  3. marked distress
  4. atleast 1x per week for 3 months
20
Q

Tx binge eating

A
  • learn to eat in response to hunger
  • eat in moderation
  • avoid restrictive diets
  • address hidden emotions and meet needs
  • overeaters anonymous
  • med: vyvanse
21
Q

med for binge eating

A

vyvanse

22
Q

eating disorder: binging food without purging

A

binge eating

23
Q

eating disorder: binging food with purging

A

bulimia

24
Q

eating disorder: fear of gaining weight

A

anorexia

25
Q

med contraindicated for pts with bulimia eating disorder

A

bupropion (increased risk seizure)

26
Q

goal body weight % for anorexia and bulemia

A

90% ideal body weight

mental health/psych (14 decks)

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