NUR 114 EATING DISORDER EXAM II - 2020 Flashcards
Extreme perfectionist Intense fear of gaining weight, denial Significant weight loss Body image disturbances, low self esteem Peculiar food handling patterns Excessive strenuous exercising Need to please others History of sexual abuse
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
Things that would be found in the physical assessment of someone with anorexia nervosa
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
Bulimia Nervosa
Normal or near-normal weight Dehydration Attrition and erosion of teeth Parotid gland enlargement * Esophageal tears, hoarseness Callus on knuckles Abdominal pain
Things you would find in the physical assessment of someone with Bulimia Nervosa
Feel Out of Control Guilt and Embarrassment No Compensatory Behavior Misguided Attempt to Self-sooth Helps Regulate Mood
Binge-Eating Disorder
Slow HR/BP Reduced bone density Muscle loss & weakness Severe dehydration Fainting, fatigue Dry hair/skin Lanugo
health consequence of anorexia
Heart Failure Gastric rupture Ruptured esophagus Tooth decay Chronic irregular BMs Peptic ulcer dx Pancreatitis
health consequences of bulimia
High BP High Cholesterol Heart disease Type II DM Gallbladder Dx
health consequences of binge-eating
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 (systolic less than 70), pulse (less than 40) & temp (less than 98)
Leukopenia (low amount of white blood cells)
lymphocytosis: T and B cells are decreased (immunity)
Risk for suicide/self mutilating behavior, severe depression
Criteria for hospitalization in regards to eating disorders
Immediate stabilization
Address acute complications
Assess for refeeding syndrome which can cause cardiovascular collapse (happens with 24 to 72 hours)
Once medically stable focus becomes underlying eating disorder
Monitor protein and kidney functions
acute hospitalization
- Acknowledge emotional and physical difficulties.
- Assess for suicidal thoughts and self-injuriousbehaviors.
- Monitor physiologic parameters (e.g., vital signs, electrolyte levels).
- Weigh the patient using strict protocol
Patient Safety Needs
- Monitor during and after meals to prevent the throwing away or purging of food.
- Recognize the patient’s distorted image andvalue of body shape.
- Educate the patient regarding the ill effects of low weight and impaired health.
- Assist in identifying strengths.
Patient Safety Needs continued…
- Restore the patient’s nutritional state
- Modify pt’s distorted eating behaviors
- Help change distorted and erroneous beliefs about weight loss and body image
Three main goals of care of those with eating disorders
black and white thinking. “if i’m not perfect that means that I failed.”
all or nothing thinking
everything is about them or related to them or a result of something that they have done. example: “my mom is so unhappy bc she has a fat daughter”
personalization
