final eating disorder Flashcards
more in females, some males, start late adolescents usually can start preadolescents
6-20% will die from disorder
Nursing Eating Disorders
Etiology
biochemical imbalance with imbalances of sertonin
Biological factors:
need for attention, don’t want to grow up, big fear of losing control, role bound regressed behavior reaction formation
Psychological factors:,
family dynamics, society very in to be thin, control over body high expectations of them
Environmental factors:
- don’t know it is happening till farther long, big baggy clothes, behaviors food in napkin make excuses why they are not hungry
General characteristics
Insidious onset
: big concern, food authority, evolved elaborate meal prep, rituals before and during, know calories
Focused on food
of control over food they eat and becoming fat
Fear loss
: straight a student, no problem with child
-may feel hopeless, depression, withdrawn
Perfectionistic
anorexic, don’t have a problem, ppl around them not theirs
Resistant to treatment
- Maintenance of less than 85% Ideal body weight
- Intense fear of adding weight
- Disturbed body image: gaining weight bc thighs touch, think ugly
- Proud of behavior, happier the thinner they get
- Amenorrhea: no periods
Anorexia Nervosa
vomit use a lot of laxatives, diuretics
Binging/purging:
anorexia
decreasing intake, exercise excessively
Restricting: anorexia
: Very distorted body image, everything about weight, bad about self, have to get thin, constantly focused on eating, restrict, loose weight start to feel good about self accomplish something positive, starvation mode feel like crap, body start to shut down bloated
Anorexia
Problems with decreased bp pulse, temp control,
Hospital super low bp
Skin very dry hair=brittle specific look
Delay gastric emptying feel very full, all backed up get very constipated, dehydrated,
Lose period, osteopenia=not taking in calcium, strar using in bones have severe spinal degenerations problem with resp because crushing spine
Mid section fluid, may have to get drained off edema
Most lethal is heart arrythmias, fluid and electrolytes out of wack
Anorexia sx:
1-4 percent of females, occur late adolescents early 20s Secretive, ashamed of behavior lack of control, normal weight to a little bit overweight
- Binge eating of large amount of food in a short amount of time with an associated feeling of lack of control over eating
- Recurrent compensatory behavior to prevent weight gain, make throw up
- Binging and compensatory behavior occur at least 2X per week for 3 months
- Self-evaluation based on body image
Bulimia Nervosa
marker food, eat first try to continue to throw up till see it, problem with serotonin, low self-esteem and self-worth
- Nonpurging
- siblicial, benige eat, purging, shame, strict diet, tension and craving
bulimia
Types:
1. Purging:
: Not as problematic, fluid and electrolyte balance, cardiac concerns, a lot of acid in esophagus erosion, abuse laxatives, diet pills
- different nature
- Teeth erosion can tell bc the enamel is gone
- Russell signs: calicus on the back of knuckle scrape teeth knot their
Bulimia Sx
Medical stabilization: throwing pvc till more stable
Goals of Treatment
Short term:
: Increase weight to 90% of IBW (anorexic)/ Maintain normal body weight (bulimic)
Reestablish appropriate eating behaviors
Increased coping skills
Increased self esteem
goal of treatment
Long-term
- DO NOT discuss food, nontopics, we are in charge of food intake, nurse in control, work on other issues take off table
- Focus on coping skills:
- Monitor intake
- Monitor weight:
- Limit activity:
- Increase privileges with increase weight:
- Matter of Fact approach:
- Be consistent:
- involve the family
Nursing Interventions
assertive skills, self-talk mechanisms
Focus on coping skills:
: start slow
shift of fluid from extracellular to intracellular causing cardiovascular and neuro problems if too fast / small amount like 400 then build up
refeeding syndrome
first thing in morning exact same scale each time, in gown, void before, back to scale so don’t know what weight is/precise to get rid of strenuous variables, best indicator if making progress
monitor weight
when very compromised, bed rest or only wheel chair until gaining weight/ exercise in the sligh, may try to at night, in shower/ may have to sleep out in the open monitor at all times
limit activity
they can work with dietician to get food, more visiting privileges
Increase privileges with increase weight:
here it is and move on, no fighting
matter of fact approach
Set limits on manipulation one staff work with at a time, no manipulation of staff
be consistent
family care, assertive with family, adult problem edu family
Dietician will be no substitution, sit with patient the entire time eating so don’t put food in napkin in plant or shoes
Involve the family:
Set length of time to eat it/ do not eat figure up calories and give supp to equal in calories= then give boost if not taken that can put ng down
After meal restricted for an hour
Mom and dad have control over what happens, say they can be force fed
Older adults are trickier Emergency detection maybe how far can go
dietary
-Indianapolis area, -Contact number: 295-0608
A lot of these people will end up in long term residential if can’t keep weight on and fail out pt tx, usually sent out of weight
Charis Center for Eating Disorders
