Eating Disorders - EXAM II Flashcards
MIA takes TOF drugs for Bulimia
T - topiramate (antiepiletic/anticonvulsant) mood stabilizer
O - ondansetron (reduces binge-purge episodes)
F - fluoxetine
Anna takes Olanzapine for her _____.
this drug is an antipsychotic and affects one’s weight, and improves cognition and body image
anorexia
Benji takes _____ for his binge eating.
orlistat
has to be used with other treatments, and is considered a lipase inhibitor - helps lose weight
1) restore the patient’s nutritional state
- anorexia: restore weight within normal range
- bulimia: ensuring a balanced metabolic state
2) modify the patient’s distorted eating disorders
3) help change the distorted and erroneous beliefs about weight loss and body image
3 main goals for all eating disorder
single event affects unrelated behaviors. “he didn’t ask me out, it must be b/c I’m fat”
overgeneralization
reasoning is absolute and extreme, black and white. “if i allow myself to gain weight, I will blow up like a balloon”
all-or-nothing thinking
consequences of something are magnified “if I gain weight, my whole weekend will be ruined”
catastrophizing
events are over interpreted as having personal significance “I know everybody is watching me eat”
personalization
subjective emotions determine reality “I know I’m fat b/c I feel fat”
emotional reasoning
discharge planning MUST address ______ _______, school, work plans, and _____-__ _______.
living arrangements, school, work, and follow-up treatments
the demands of a replenished circulating system overwhelm the capacity of a nutritionally depleted cardiac muscle. results in cardiovascular collapse.
- can occur up to 2 weeks after post initiation of nutritional replenishment.
- can supplement with thiamine supplement and multivitamin prophylactically
- treated by slowing the feeding rate, and involve the dietitian and other healthcare professionals in the decision making for continuing care.
Refeeding Syndrome
state in which the body is no longer starving and is building and repairing tissue
metabolic state
state in which the body is starving and is breaking down tissue including fat and muscle
catabolic state
there are severe _______ and _____ shifts in the early stage of nutritional replenishment.
fluid and electrolyte
-edema
-congestive heart failure
-vitamin deficiency
-glucose metabolism
-delirium
-seizures
-arrhythmia
-sudden death
(look for decreased heart contractility, hypotension, ataxia, confusion, lethargy, seizures, acute respiratory failure, thrombocytopenia.)
s/sxs of refeeding syndrome
-athletes are at an increased risk for eating disorders especially those who perform independently (wrestlers, swimmers, gymnasts, golfers)
Key characteristics
-intense fear of gaining weight, denial
-extreme perfectionist, over control of environment (in denial that there is an issue with their weight)
-Peculiar food handling patterns (may cook but never eat their meals, cutting their food a certain way, etc)
-Excessive strenuous exercising (main thing that consumes their day – exercising for 6 hours per day)
-Main goal with client will be nutrition and maintain an adequate diet and an acceptable weight for their category
Anorexia Nervosa
- Severe underweight (< 85% of IBW)/Muscle wasting (Cachectic)
- Lanugo
- Amenorrhea *
- Hypotension, bradycardia, hypothermia, mottled skin, cool skin, yellow skin pallor (carotenemia)
- Dry skin/Dry thin hair that falls out, brittle nails
- Peripheral edema
- Cardiac arrhythmias
s/sxs of anorexia
- Binge eating behaviors with no control
- Purging by vomiting, abuse of laxatives or diuretics
- Problems with interpersonal relationships, self-concept, impulsive behavior
- Increased anxiety, depression
- Possible chemical dependency, impulsive stealing
- Recognize their problem
characteristics of bulimia nervosa
- Normal or near-normal weight
- Dehydration (NA and K levels are of concern)
- Attrition and erosion of teeth
- Parotid gland enlargement (upper inside of the cheeks)
- Esophageal tears, hoarseness
- Callus on knuckles (sticking hand down throat to vomit)
- Abdominal pain
s/sx of bulimia nervosa
- 30% weight loss over 6 month period/rapid weight loss
- Profound electrolyte imbalances: Hypokalemia <3 mEq/L
- Cardiac disease related: cardiomyopathy, dysrhythmias, sudden cardiac arrest
- Decreased BP, pulse & temp (pulse <40, temp less than 98F, and blood pressure systolic is <70)
- Leukopenia, lymphocytosis
- Risk for suicide/self mutilating behavior, severe depression
hospitalization criteria
low levels of white blood cells
leukopenia
