week 6 notes Flashcards
anorexia, bulimia, dementia, & delirium
manifestations of anorexia nervosa
patches of hair loss on scalp
decreased vitals
anemia
constipation
a nurse is reviewing the lab results of a client who has bulimia nervosa. which of the following results should the nurse expect ?
- elevated potassium levels
- elevated thyroid hormone levels
- elevated sodium levels
- elevated pancreatic enzyme levels
- elevated pancreatic enzyme levels
*everything else is decreased
anorexia nervosa
self-induced restriction of nutritional intake leading to a significantly lower than normal body weight accompanied w distorted body image & fear of being fat
*rituals – tiny pieces, no food touching
Bulimia nervosa
BINGEING on large amounts of food then PURGING through self-induced vomiting in an effort to prevent gaining weight
*abuse laxatives & diuretics
Binge eating disorder
recurrent episodes of bingeing accompanied by emotional distress
Avoidant restrictive food intake disorder
persistent failure to meet nutritional needs, inflexible eating behaviors, & fear based food restriction
Othorexia
vs
Diabulimia
Othorexia = obsession w healthy eating leading to disturbance in adequate nutritional intake
Diabulimia = person w type 1 DM redues/stops taking insulin to drop weight
Pica
consuming inedible objects
*children
rumination disorder
intentional regurgitation of food in a repetitive manner, the rechewing, reswallowing, or spitting it out
lanugo
*ANOREXIA
fine downy hair growth on skin
Russel’s sign
callouses & bruising on the knuckles resulting from self-induced vomiting by sticking one’s finger down the throat
Bulimia manifests as
at near or ideal body weight
parotid gland enlargement
Russels sign (calluses)
binge-purge cycle
dental erosion
skin problems
*hypokalemia
*GI problems
*dependency on laxatives
refeeding syndrome
dangerous shift of fluid & electrolytes that occur within the body when reintroduced too quickly = heart failure
**anorexia
“food is your medicine”
nursing intervention for eating disorders
diet to promote cognitive function in alzheimer’s patients
MIND diet
*mediterranean diet
gnosis vs praxis
gnosis = recognition of faces
praxis = imitating gestures or learned movements
medications for delirium include
benzo’s, barbituates, & anti-psychotics
Alzheimer’s Disease presents with
amyloid plaques & tau tangles
olfactory deficits
10 yr survival rate
moderate Alzheimer’s presents with
-ASSISTANCE bathing & getting dressed
- sundowning (worse at night)
- confabulation (distorted memories)
- aphasia
-apraxia (inability to perform even with physical ability in tact) - agnosia (inability to recognize even w senses in tact )
severe alzheimers presents with
*TOTAL CARE
- agraphia = inability to read or write
- hypermetamorphisis = feeling the need to touch everything in sight
-hyperorality = putting everything in the mouth
Huntington’s Disease is evident on
chromosome 4
music therapy for clients with Alzheimers..
evokes memories
symptoms of delirium include
*HALLUCINATIONS
*VITAMIN DEFICIENCIES
confusion
irritability
hyperactivity
sweating tremors
tachycardia
impaired level of consciousness
alzheimer’s disease is diagnosed using a
PET SCAN
in clients with dementia, music therapy helps
improve appetite
hospital admission criteria for eating disorders
less than 10% body fat
30% weight loss over 6mo
inability to gain weight outpatient
*danger to self
Type 1 vs Type 2 Anorexia
Type 1 = restrict caloric intake
Type 2 = purging, laxatives, induced exercise
manifestations of anorexia
*hypokalemia
- amenorrhea
- cachectic (muscle wasting)
- constipation
- decreased vitals
- dizziness / fainting
- lanugo (hypothermia)
- pallor
- palpitations
4 items of nursing process when ASSESSING anorexia
safety
level of insight
understanding of disease
eat 75% of meals
IMPLEMENTING nursing process for anorexia
*behavioral (privileges take away)
- 30 min time frame to eat
- weigh after void (same time & clothes)
- observe patient while eating & 1 hour after
medication for anorexia only
*Olanzipine –weight gain & obsessive thoughts
medication for bulimia
*Fluoxetine – SSRI
bulimia + co-morbidity
executive functioning involves
ability to manage daily tasks
decisions & planning
delirium is a
comorbidity that affects the elderly & younger population
delirium manifests
suddenly w/ elevated unstable vitals
*hallucinations
*illusions
*decreased visiospatial ability
decreased functioning & focus
labile (moody)
restless
anxious
motor agitation
sundowning (worse @ night)
3 types of delirium
- Hyperactive = mood swings
- Hypoactive = drowsy & least recognized
- Mixed = switching
interventions for delirium
*well-lit room w low level stimuli
- fall risk = socks
- reality orientation
- introduction w each interaction
- 1:1 sitter
- room close to nursing station
primary vs secondary dementia
primary= irreversible
secondary = delirium not treated causing dementia
dementia defense mechanisms
avoidance of questions
confabulation
denial
preservation (repeats to avoid ?)
dementia manifests as (4 a’s)
amnesia
agnosia = loss of sensations
aphasia = loss of words
apraxia = loss of movement
3 medications for mild to moderate alzheimers
** take @ END of day
Donepezil hydrochloride
Galantamine hydrobromide
Rivastigmine tartrate
*slows progression
* GI side effects - n/v/d
*bradycardia
*syncope
medication for moderate to severe AD
Memantine hydrochloride
limited benefits
causes:
headache
dizziness
constipation
dementia defense mechanisms
denial
confabulation
preservation
avoidance of questions
