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N236 Mental Health Eating Disorders
Terms in this set (51)
Anorexia patients are they preoccupied with food and the rituals of eating or not?
yes they preoccupied food and rituals but will not eat.
Anorexics are 85% less than?
normal wt person for their size.
Anorexic have a disturbed
body perception, see themselves as fat.
How much of this disease are males?
Pt with anorexia nervosa avoid?
social situations and retreat and stay isolated in their rooms a lot.
Anorexics tend to be?
*rigid exercise programs
*lessen sex drive
Two types of anorexics are?
*pinged and purge
*restricts food intake
Average onset of bulimia illness is ? and anorexia is?
Anorexia big deal is that the only thing is their life they can control is?
Bulimia nervosa the patients eat large quantities of food and calories and?
Most bulimics are what weight?
normal or slightly above
Subjective symptoms of bulimia are?
Shared features of both diseases?
*restriction of intake at times esp anorexics
*binging and overeating at times esp bulimic
*laxatives, or diuretics, over-exercising, extreme concern about appearance, perfectionist traits, dissatisfied with appearance and performance. They believe self-worth is solely on appearance. Discomfort in social settings , esp with males, misperception of body size and shape and fat low self esteem.
Differences between the two diseases?
*anorexia early onset , very low weigh, hormonal imbalance, constipation if not using laxatives.
*bulimia later onset , more normal wt, fluid and electrolyte imbalance, gastro-intestinal problems related to binging and purging.
Mortality rate for eating disorders is very ?
high, and suicide is also a risk.
Eating disorders nursing interventions?
*monitoring caloric intake
*monitor electrolyte status
*monitor for purging
*monitor activity level (nothing extreme)
*therapy and support groups
*promote decision making in other areas
*promote positive self concept and interactions with others
*identify positive qualities
*teach about disorders
*behavior modification program with incentives for wt gain or lack or purging
*teach social skills
*identify non weight related interests
Therapeutic milieu for the eating disorder pt?
*closely observe patients
*talk to nurse or team member if they want to purge
*involve pt family in tx
*respond with consistency
*participation in classes: art , etc
*attend group therapy sessions
Comorbidities include are?
*major depressive disorder
*dysthymias (electrolyte imbalance)
Parental pressure is a big role in the?
Environmental factors are?
pressure from society to have the perfect body
These people tend to have been ____ ____ as children?
They tend to participate in?
elite level of competition
Nursing hx should include?
*pt perception of the issue
*hx of dieting
*methods of wt control (restricting , purging, exercising)
*value attached to a certain wt and shape
*interpersonal and social functioning
*difficulty with impulsivity and compulsivity
Family genetics plays a part esp if?
mom or sister has an eating disorder
Interpersonal relationship with feeling that their parents
want them to be perfect and succeed.
Psychological influences are?
*separation and individuation conflicts
*feeling of ineffectiveness
*distorted body image
Males tend to participate in sports with low wt like?
Males with a history of obesity tend to be?
high risk for eating disorders
Family and interpersonal relationships are?
frequently troublesome an chaotic , reflecting a lack of nurturing.
Anorexia/bulemia can cause?
*decreased body temperature
*lanugo (downy hair) face and back
*yellow skin; mottled
*poor skin turgor/dehydrated
People with anorexia tend to?
*wear baggy clothes
*not buy new clothes to hide the major wt loss
*eat grapes and apples
If a patient purges too much it will cause?
erosion of their teeth from the acid .
Anorexics are terrified of?
Pt with eating disorders tend to?
*low self esteem
*difficulty with relationships
Patients with eating disorders have cognitive disorders and tend to generalize and say things like:
*other girls don't like me because I am fat
*If I eat desert, I will gain 50lbs.
*My life is over if I gain wt.
*I know I look bad because I am bloated
*Everyone is staring at me because I am fat. (and they are deathly thin)
Criteria for inpatient treatments includes?
*rapid wt loss
*wt loss >30% in 6 months
*unsuccessful wt gain
*failure to adhere to treatment contract
*Ekg changes/dysrythmia from low potassium
Why do they look yellow?
elevated carotene levels
How is their thyroid function?
Dehydration stimulated Aldosterone production causing the body to?
sodium and water retention and potassium excretion.
Electrolytes are common in purgers causing?
Testing for eating disorders are?
*eating disorder inventory
*body attitude test
*diagnostic survey for Eating disorder
Provide a therapeutic mileau and promote cognitive-behavioral therapy with ?
Use behavioral contracts to?
modify clients behavior
Reward the client for?
*finishing a meal
*eating a certain amount of calories
How can you stop them from purging?
*closely monitor them and go to the restroom with them.
Provide nutritional education and correct any misconceptions regarding food, meal planning, and food selection. Always consider the clients?
preferences and ability to consume food when developing an eating plan.
Establish a meal plan that is?
*inflexible/only permitting food during scheduled tie
*small frequent meals/ to not overwhelm them
*high in fiber/constipation
*low in sodium to control fluid retention
*limit high fat , gassy foods during the start of tx.
Many clients are put on SSRI's for tx of depression, make sure the client knows?
*it takes 1-3 weeks to work
*notify doctor if sexual dysfunction occurs and is intolerable
Make sure that a dietitian is consulted and care after discharge is?
*assist client in maintenance plan
*follow-up in outpatient setting
*participation in support group
*continue individual and family therapy
What is re-feeding syndrome?
*is the circulatory collapse that occurs completely compromised cardiac system is overwhelmed by a replenished vascular system after normal fluid intake resumes.
*over a week long
*monitor serum and electrolyte balance (don't over-correct)
*oral thymine and B vitamins are given , too.
If patient has severe bradycardia, dysthrmias, ore hypo-tension place on?
*continuous cardiac monitor
*monitor vitals closely
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