Eating Disorders - EXAM II

Question 1

MIA takes TOF drugs for Bulimia

Answer 1

T - topiramate (antiepiletic/anticonvulsant) mood stabilizer
O - ondansetron (reduces binge-purge episodes)
F - fluoxetine

Question 2

Anna takes Olanzapine for her _____.

this drug is an antipsychotic and affects one’s weight, and improves cognition and body image

Answer 2

anorexia

Question 3

Benji takes _____ for his binge eating.

Answer 3

orlistat

has to be used with other treatments, and is considered a lipase inhibitor - helps lose weight

Question 4

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

Answer 4

3 main goals for all eating disorder

Question 5

single event affects unrelated behaviors. “he didn’t ask me out, it must be b/c I’m fat”

Answer 5

overgeneralization

Question 6

reasoning is absolute and extreme, black and white. “if i allow myself to gain weight, I will blow up like a balloon”

Answer 6

all-or-nothing thinking

Question 7

consequences of something are magnified “if I gain weight, my whole weekend will be ruined”

Answer 7

catastrophizing

Question 8

events are over interpreted as having personal significance “I know everybody is watching me eat”

Answer 8

personalization

Question 9

subjective emotions determine reality “I know I’m fat b/c I feel fat”

Answer 9

emotional reasoning

Question 10

discharge planning MUST address ______ _______, school, work plans, and _____-__ _______.

Answer 10

living arrangements, school, work, and follow-up treatments

Question 11

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.

Answer 11

Refeeding Syndrome

Question 12

state in which the body is no longer starving and is building and repairing tissue

Answer 12

metabolic state

Question 13

state in which the body is starving and is breaking down tissue including fat and muscle

Answer 13

catabolic state

Question 14

there are severe _______ and _____ shifts in the early stage of nutritional replenishment.

Answer 14

fluid and electrolyte

Question 15

-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.)

Answer 15

s/sxs of refeeding syndrome

Question 16

-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

Answer 16

Anorexia Nervosa

Question 17

• 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

Answer 17

s/sxs of anorexia

Question 18

• 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

Answer 18

characteristics of bulimia nervosa

Question 19

• 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

Answer 19

s/sx of bulimia nervosa

Question 20

• 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

Answer 20

hospitalization criteria

Question 21

low levels of white blood cells

Answer 21

leukopenia