T3 - Eating Disorders (Josh) Flashcards
Types of Eating Disorders
Anorexia Nervosa
Bulimia Nervosa
Obesity
Binge-Eating Disorder (BED)
The appetite regulation center of the brain is in the —
hypothalamus
Anorexia Nervosa affects approximately – of young women and is predominent in ages –
1%
12-30 yrs
Which is more prevalent, Bulimia Nervosa or Anorexia Nervosa?
Bulimia Nervosa (4%)
The onset of bulimia nervosa occurs when?
late adolescence
early adulthood
Obesity is BMI of
30 or greater
What percentage Adult Americans are overweight?
- 5%
* 35% are obese
With Anorexia the client is – with food
preoccupied and obsessed
Clinical Anorexia is – below their ideal weight.
15% or more
S/S of Anorexia:
- 15% OR MORE UNDER IDEAL WT.
- EMACIATED
- HYPOTHERMIA
- BRADYCARDIA
- HYPOTENSION
- EDEMA
- LANUGO
- DRY, BRITTLE HAIR
- AMENORRHEA
- YELLOW SKIN
- CONSTIPATION
- HEART FAILURE
- ABNORMAL LABS
- ELECTROLYTE IMBALANCE
- MUSCLE WEAKNESS
Which is characteristic of the diagnosis of anorexia nervosa?
a) Obsession with weight gain
b) Body image disturbance
c) Disregard for the feelings of others
d) Healthy family relationships
b) Body image disturbance
Bulimia is characterized by – followed by —-
binging
purging
Bulimia s/s
- BINGING FOLLOWED BY PURGING
- MAY RID BODY OF EXCESS CALORIES BY SELF-INDUCED VOMITING
- MAY MISUSE LAXATIVES, DIURETICS, ENEMAS
- FASTING OR EXCESSIVE EXERCISE
- NORMAL WT OR SLIGHTLY UNDER OR OVER
- DEPRESSION, ANXIETY, SUBSTANCE ABUSE ARE COMORBID
Callouses on hands are a sign of —
bulimia
Peripheral edema is a sign of —
bulimia
Parotid edema is a sign of –
bulimia
What happens to teeth w/ Bulimia?
dental erosion
Which assessment finding would the nurse expect in clients diagnosed with bulimia? They:
a) are below normal weight.
b) binge when they experience hunger.
c) will be highly motivated to seek help.
d) are within their normal weight range.
d) are within their normal weight range.
- Clients diagnosed with bulimia nervosa are often able to maintain a normal weight by purging after binging.
Calculate BMI:
WT in kg divided by HT in Meters squared
How does Binge Eating Disorder (BED) differ from Bulimia?
In BED, the individual does not engage in behaviors to rid the body of the excess calories.
Which eating disorder can lead to Obesity?
BED (Binge Eating Disorder)
A client is 5’8’’ tall and weighs 105 pounds. The client has been taking laxatives daily, an self-induces vomiting after eating. Which is the priority nursing diagnosis for this client?
a) Ineffective denial
b) Disturbed body image
c) Low self-esteem
d) Imbalanced nutrition: less than body requirements
d) Imbalanced nutrition: less than body requirements
In planning to treat eating disorder, what is the goal?
normalize eating habits
What is a realistic weight gain goal for anorexia?
2-3 lbs / wk
When should the client be weighed?
daily early in AM after voiding
What should we do after meals?
stay w/ client 30 mins to 1 hr after meal
Limit or promote exercise w/ Anorexia?
Limit
Should we argue or bargain w/ the client w/ an eating disorder?
no
Treatment modalities for Eating Disorder
BEHAVIOR MODIFICATION
MILIEU
GROUP
INDIVIDUAL
FAMILY
PSYCHOPHARMACOLOGY
Ways to promote Cognitive-Behavioral Therapies
Cognitive Reframing
Relaxation Techniques
Journal Writing
Desensitization Exercises
A nurse is preparing to obtain a nursing history from a client who has a new diagnosis of anorexia nervosa. Which of the following questions are appropriate for the nurse to include in the assessment?
A. “What is your relationship like with your family?”
B. “Why do you want to lose weight?”
C. “Would you describe your current eating habits?”
D. “At what weight do you believe you will look better?”
E. “Can you discuss your feelings about your appearance?”
A. “What is your relationship like with your family?”
C. “Would you describe your current eating habits?”
E. “Can you discuss your feelings about your appearance?”
Some obese individuals take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated w/ the use of amphetamines that makes this practice undesirable?
a) Bradycardia
b) Amenorrhea
c) Tolerance
d) Convulsions
c) Tolerance
Psychoanalytically, the theory of obesity relates to the individual’s unconscious equation of food w/
a) Nurturing and caring
b) Power and control
c) Autonomy and emotional growth
d) Strength and endurance
a) Nurturing and caring
Which of the following physical manifestations would you expect to assess in a client suffering from anorexia nervosa?
a) Tachycardia, HTN, hyperthermia
b) Bradycardia, HTN, hyperthermia
c) Bradycarda, hypotension, hypothermia
d) Tachycardia, hypotension, hypothermia
c) Bradycarda, hypotension, hypothermia
What will the face of Bulimia client look like?
chipmunk cheeks
- due to parotid edema where the food particles block the parotid glands in mouth
What will finger of Bulimia client look like?
scars and callouses from the stomach acid
When you vomit, what do you lose?
Na
Cl
Nurse Jones is caring for a client who has been hospitalized w/ anorexia nervosa and is severely malnourished. The client continues to refuse to eat.
What is the most appopriate response by the nurse?
a) You know if you don’t eat, you will die.
b) If you continue to refuse to take food orally, you will be fed through a NG tube.
c) You might as well leave if you are not going to follow your therapy regime.
d) You don’t have to eat if you don’t want to. It is your choice.
b) If you continue to refuse to take food orally, you will be fed through a NG tube.
Which of the following medications has been used w/ some success in clients w/ anorexia nervosa?
a) lorcaserin
b) diazepam
c) fluoxetine
d) carbamazepine
c) fluoxetine
Jane is hospitalized on the psych unit w/ Bulimia. Which of the following symptoms would be congruent w/ the diagnosis?
a) Binging, purging, obesity, hyperkalemia
b) Binging, purging, normal weight, hypokalemia
c) Binging, laxative abuse, amenhorria, severe weight loss
d) Binging, purging, severe weight loss, hyperkalemia
b) Binging, purging, normal weight, hypokalemia
The binging episode is thought to involve:
a) A release of tension, followed by feelings of depression
b) Feelings of fear, followed by feelings of relief
c) Unmet dependency needs and a way to gain attention
d) Feelings of euphoria, excitement, and self-gratification
a) A release of tension, followed by feelings of depression
Concern w/ Refeeding Syndrome.
do it in small increments or you can overload their bodies ability to compensate and they could die
What is the effective dosage for fluoxetine for overweight clients?
60 mg/day
How does fluoxetine work to treat BED?
SSRI
- decreases cravings for carbs, thereby deceasing the incidence of binge eating
Drugs shown to work for BED
fluoxetine (SSRI) imipramine nortryptaline amitriptyline phenelzine
Drugs that help w/ the comorbid depression associated w/ anorexia?
SSRIs
- fluoxetine
- sertraline
