TOPIC 12 - feeding and eating disorders Flashcards

Question

three features of anorexia nervosa

Answer 1

eats less afraid of gaining weight distorted body image

Answer 2

Determine the need for hospitalization Assess family needs (i.e., resources, education) Assess client’s acceptance of therapeutic modality Physical examination & lab results BMI to determine severity of condition Obtain client’s dieting history Assess what value the client attaches to body image

Answer 3

by patients BMI

Answer 4

Mild : ≥17 kg/m2 Moderate : 16 - 16.99 kg/m2 Severe : 15 - 15.99 kg/m2 Extreme : <15 kg/m2

Answer 5

Terrified of gaining weight Preoccupied with food Considers themselves fat, regardless of their actual weight and size Cuts food into small pieces & moves it around on the plate (but doesn’t eat it) May eat paper to feel “full” Judges their self worth by their weight potential purging use of laxatives, diuretics or vomiting vigorous exercise

Answer 6

Lanugo Carotenemia Acrocyanosis Cachexia Enlarged parotid glands (in binge/purge type)

Answer 7

osteoporosis fatty degeneration of liver amenorrhea elimination changes : constipation, hematuria, proteinuria

Answer 8

clinical condition characterized by yellow pigmentation of the skin (xanthoderma) and increased beta-carotene levels in the blood. In most cases, the condition follows prolonged and excessive consumption of carotene-rich foods, such as carrots, squash, and sweet potatoes.

Answer 9

(painless bluish or purple coloring of the hands and feet caused by slow circulation)

Answer 10

clinical condition characterized by yellow pigmentation of the skin (xanthoderma) and increased beta-carotene levels in the blood. In most cases, the condition follows prolonged and excessive consumption of carotene-rich foods, such as carrots, squash, and sweet potatoes.

Answer 11

Lethargy, sluggishness, or feeling tired all the time Iron deficiency (anemia) Low body temperature, so the person often feels cold Dry, yellowish skin (carotenemia) Growth of fine hair all over the body (lanug0) Brittle hair and nails Skipping or no longer having monthly menstruation Infertility Muscle wasting and weakness Low blood pressure, with slow breathing and pulse Severe constipation and abdominal pain Thinning of the bones (osteopenia or osteoporosis) Damage to the heart, including slow heart rate and possible heart rhythm problems Brain damage or multi-organ failure Fainting Dehydration Increased Urination Decrease interest in sex Sleep problems Sensitive to light, loud noise, and trouble concentrating Low back pain

Answer 12

Hypokalemic alkalosis is seen in binge/purge AN – d/t self-induced vomiting, use of laxatives, and/or diuretics

Answer 13

Symptomatic hypotension & orthostatic BP changes Bradycardia Cardiac murmur Prolonged QT interval Sudden cardiac arrest

Answer 14

Electrolyte imbalances Hypokalemic alkalosis (primarily seen in binge/purge type) Low thyroid hormone levels Elevated cholesterol levels Leukopenia, anemia Lymphocytosis

Answer 15

Weigh client the same time of day in similar undergarments with the client’s back to the scale (usually done once weekly) DO NOT share weight with client Monitor during meals Ensure clients go to groups right after meals to process cognitive & affective feelings regarding food & eating Strict I and O Recognize distorted self image Avoid a authoritarian or parental role to build alliance and trust (the most effective treatments use a multidisciplinary approach)

Answer 16

Acknowledge emotional and physical difficulties. Assess for suicidal thoughts and self-injuriousbehaviors. Monitor physiologic parameters (e.g., vital signs, electrolyte levels). Weigh the client using strict protocol. 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 client regarding the ill effects of low weight and impaired health. Assist in identifying strengths.

Answer 17

treatment for anorexia nervosa too rapid reintroduction of nutrition

Answer 18

olanzapine (atypical antipsychotic) Affects weight gain and can improve cognition & body image TCA's and SSRI's also used Zyprexa (olanzapine) EBP findings to support treatment for anorexia Prozac (fluoxetine) EBP findings for treatment of bulimia (decrease obsessive thoughts and vomiting)

Answer 19

does the client need medical stabilization?

Answer 20

Physical examination & labs (electrolytes (BMP), glucose, thyroid, CBC, ECG) Psychiatric evaluation(screen for depression, anxiety, suicidal ideation) Ask directly about use of weight-loss aids(e.g., laxatives, diuretics, diet pills, amphetamines, energy pills, energy drinks, or diet teas)

Answer 21

frequency of compensatory behavior NOT BMI

Answer 22

moderate : 4-7 times per day severe : 8-13 times per day extreme : 14 or more

Answer 23

Binge eating Frequent vomiting after binging Laxative and diuretic abuse Depression Issues with interpersonal relationships Poor self-concept Impulsive behaviors (stealing) Anxiety and compulsivity Possible chemical dependency

Answer 24

Cardiomyopathy (ipecac toxicity) Cardiac dysrhythmias Sinus bradycardia Sudden cardiac arrest Orthostatic changes in pulse & blood pressure

Answer 25

metabolic acidosis hypochloremia hypokalemia

Answer 26

Attrition and erosion of teeth Loss of dental arch Diminished chewing ability

Answer 27

Parotid gland enlargement Esophageal tears (result of self-induced vomiting) Gastric dilation

Answer 28

knuckle callouses

Answer 29

excessive exercising

Answer 30

Assess mood and presence of suicidal thoughts/behaviors Monitor vitals and electrolyte levels as needed Monitor weights as needed Educate the client that fasting can lead to continuation of the binge/purge cycle Monitor client during and after meals Acknowledge the patient’s overvalued ideals of body shape and size without minimizing or challenging patient’s perceptions Encourage client to keep a journal of thoughts and feelings

Answer 31

binge eating disorder

Answer 32

Repeated binge eating, feeling a lack of control over eating, and feeling distressed by it Eating alone due to embarrassment Eating large amounts when not physically hungry Eating more rapidly than normal Eating until uncomfortably full Feeling disgust, sadness, or guilt after binge eating

Answer 33

Recurrent episodes of thinking about and eating large amount of food occur in a short period Involves eating large amounts of food even when not physically hungry Binge eaters report that binge eating is soothing and helps regulate moods Feelings of disgust, depression, and guilt are expressed after binging Clients with binge-eating disorder often eat alone due to embarrassment Binge-eating disorder does not involve regular purging, heavy exercise, or fasting

Answer 34

Repeated binge eating Feeling a lack of control over eating, and feeling distressed by it Eating alone due to embarrassment Eating large amounts when not physically hungry Eating more rapidly than normal Eating until uncomfortably full Feeling disgust, sadness, or guilt after binge eating

Answer 35

Assess mood & psychosocial factors Work with interdisciplinary team to determine treatment objectives Provide nutritional counseling

Answer 36

Milieu inpatient therapy: CBT/DBT (cognitive distortions are challenged) Individual, group, or family therapy (CBT/DBT); psychodynamic therapy Self-care promotion (improving social skills, coping skills, decision-making, problem-solving abilities) Health teaching Health promotion