Mr. D's Eating Disorders
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| Body image is | subjective
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| Body image is based on | the personal perception of self and the reactions of others
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| Eating disorders are a direct result of | perceived body image disturbances
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| Eating disorders have a deep rooted | psychological aspect
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| Intervention (for eating disorders) is | imperative
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| Mortality rate for eating disorders is | high and suicide is also a risk.
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| True or False? You have to be underweight to have an eating disorder. | False
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| True or False? Only teenage girls and young women are affected by eating disorders. | False. 90% women. 10% men
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| True or False? People with eating disorders are vain. | False
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| True or False? Eating disorders are not that dangerous. | False
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| Eating disorders have the ______ mortality rate of any mental illness. | highest
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| Anorexia nervosa occurs predominantly in females between the ages of | 12 to 30
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| Less than ___% of cases are men. | 10%
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| Anorexia is characterized by a fear of | obesity
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| Symptoms of anorexia nervosa: | hypothermia, depression, weight loss, irregular periods, hording food, anxiety, brittle dry hair and nails, fine body hair growth, malnourished, muscle wasting, weakness, severe constipation
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| 2 diagnostic criteria for anorexia nervosa: | Binge/purge. Restricting.
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| Binging | Eating a lot of food at one sitting.
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| Purging | Self induced regurgitation or vomiting after eating.
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| Restricting type | Self induced food restriction. < 300-400 calories per day.
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| Developmental risk factors with anorexia nervosa: | May have issues with control.
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| Family risk factors for anorexia nervosa: | Controlling, Strict household with High Expectations.
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| Bulimia | An episodic, uncontrolled, compulsive rapid ingestion of large quantities of food over a short period of time(binge), followed by extreme measures to rid the body of excess calories(purge).
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| Bulimia is _____ prevalent than anorexia. | more
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| The average age of onset for bulimia nervosa is | 15-18
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| Patients with bulimia nervosa control calories by: | diuretics, laxatives, exercise, enema, vomiting
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| Weight fluctuations are common, however most bulimics are _______ normal weight range. | within
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| Developmental risk factors for bulimia nervosa | issues with autonomy
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| Family risk factors for bulimia nervosa: | Too much autonomy. Chaotic, unstructured, permissive, loose household. No one cares about/for you.
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| Symptoms of bulimia nervosa: | Misuse of laxatives, diuretics, and enemas. Live in fear of gaining weight. Preoccupied with body shape and weight. Tooth decay. Eating past point of discomfort.
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| When conducting a personal history on a client with an eating disorder, you will find that the client with anorexia and bulimia are often described as | perfectionists with above-average intelligence and being achievement oriented. They are focused on pleasing others.
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| General appearance, Anorexia: | tired, thin, malnourished, wearing clothes that are 2-3x's larger than normal
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| General appearance, Bulimia: | Look normal
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| Mood and affect, Anorexia: | depression, unhappy, alone, flat bland facial expression
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| Mood and affect, Bulimia: |
cheerful, happy, good communication skills, superficial, guilty
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| Judgment and insight, Anorexia: | Very poor insight, very poor self judgment. Still believe that they are fat.
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| Judgment and insight, Bulimia: | Good insight about self problems.
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| Self-Concept, Anorexia and Bulimia: | low self esteem
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| Labs to check for eating disorders. | hypokalemia, anemia and leukopenia, decreased bone density, abnormal thyroid function, abnormal blood glucose, ECG
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| 2 diagnostic criteria for bulimia nervosa: | Purging. Non purging.
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| Nursing Dx for eating disorders: | 1 (most important)Imbalanced nutrition less than body requirements. 2 Disturbed body image.
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| Anorexia diet: | Water(6-8 glasses). Protein(lean meat, eggs, vegetables, protein shakes). Multivitamins.
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| Medications for eating disorders: | SSRI
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| Care after discharge for eating disorders? Encourage client to develop and maintain ___ program. | dietary
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| Care after discharge for eating disorders? Encourage follow-up treatment in an __ setting. | outpatient
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| Care after discharge for eating disorders? Encourage client participation in a ___ _____. | support group
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| Care after discharge for eating disorders? Continue ___ and ___ therapy. | individual and family
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| Criteria for inpatient treatment includes: Rapid weight loss greater than ___% of body weight over ___ months. | 30% over 4 months.
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| Criteria for inpatient treatment includes: Severe ___ | depression
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| Criteria for inpatient treatment includes: ____ behavior | suicidal
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| Criteria for inpatient treatment includes: Unsuccessful weight ____ in ____ treatment | gain outpatient
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| Treatment modalities for eating disorders. ____ modification. | behavior
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| Treatment modalities for eating disorders. ___ therapy. | individual
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| Treatment modalities for eating disorders. f____ therapy. | family
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| Obesity is not considered a ___ disorder. | psychiatric
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| Genetics: When both parents are obese, there is an __% chance that the offspring will be obese. | 80%
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| Treatment for anorexia nervosa. Reinforce __ behavior. | +
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| Treatment for anorexia nervosa. Educate to inform due to ___ deficit. | knowledge
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| Treatment for anorexia nervosa. Participation in ___ choice. | food
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| Biological influences of eating disorders: | Hypothalmus. Serotonin & NE
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| Psychodynamic causes of eating disorders: | Strict controlling family & sexual abuse.
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| Eating disorders begin and peak in ____ years. | teenage high school
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| Anorexia is ____ common. | less
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| Bulimia is ____ common. | more
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| Anorexia people look ___. | emaciated
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| Bulimic people look ___. | normal
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| Anorexia people are ___ weight. | under
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| Bulimic people may be at ___ weight. | normal
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| Anorexic people are ___ to detect. | easy
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| Bulimic people are ___ to detect. | hard
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| Eating disorder treatments: Patient Focused | PERCEPTION OF FOOD. Preoccupied with food and weight. Focus on eating habits. Nutrition meal plan. Include choices in meal plans.
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| Eating disorder treatments: Treatment of Depression | INVOLVE IN ACTIVITIES(keep 'em busy). Anxiety. Find out origin of depression(abuse, bullying, molested). Build trust. Medication(SSRI).
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| Eating disorder treatments: Restoration of Function | ASSES ROLE PRIOR TO DISORDER. Back to baseline(if lose job, find another one). Monitor I&O. Daily and nightly weigh-in. Assist in resume making. Act like a social worker.
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| Eating disorder treatments: Group Therapy | Long term maintenance. Peer relationships, around people who have been there and done that.
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| Eating disorder treatments: Family Involvement | Talk to family about child's eating disorder.
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| Nsg Dx: Imbalanced nutrition. S & Sx | Weight loss. Poor skin turgor. Bradycardia. Hypotension. Cardiac arrhythmias.
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| Nsg Dx: Imbalanced nutrition. Nsg Ax | Determine nutritional requirements. Explain behavior modification plan. Daily weigh-ins and I&O. Asses skin turgor and mucous membranes. Stay with client during meals and 1hr after meals.
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| Nsg Dx: Imbalanced nutrition. Outcomes | Client gains 2-3lbs per week. Nourished and hydrated. Adequate calories. No food stash. No self-induced vomiting.
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| Nsg Dx: Disturbed body image. S & Sx | Distorted body image. Self-depreciating thoughts. Need to excel. Need to prove self to others. Depressed mood. Anxiety. Thoughts of possible failure.
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| Nsg Dx: Disturbed body image. Nsg Ax | Help client develop realistic perception of body image. Allow client independent decision-making. Give + feedback. Help client accept self. Convey knowledge that perfection is unrealistic.
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| Nsg Dx: Disturbed body image. Outcomes | Client acknowledges that image of body as "fat" is a misconception. Client verbalizes positive self-attributes.
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| Some obese individuals take amphetamines to suppress appetite and help them lose weight. What is an adverse effect associated with amphetamines? | Tolerance.
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| Psychoanalytically, the theory of obesity relates to the individual's unconscious equation of food with: | Nurturance and caring.
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| From a physiological point of view, the most common cause of obesity is probably: | More calories consumed than expended.
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| Nancy, 14yr, has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refusing to eat. What is the primary nursing diagnosis for Nancy? | Imbalance nutrition: Less than body requirements.
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| What is a physical manifestation that you would expect to asses in a client suffering from anorexia nervosa? | Bradycardia, hypotension, hypothermia.
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| Nurse Jones is caring for a client who has been hospitalized with anorexia nervosa and is severely malnourished. The client continues to refuse to eat. What is the appropriate response by the nurse? | "If you continue to refuse to take food orally, you will be fed through a nasogastric tube."
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| Which medication has been used with some success in clients with anorexia nervosa? | Fluoxetine (Prozac).
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| Jane is hospitalized on the psychiatric unit. She has a history and current diagnosis of Bulimia Nervosa. Which symptoms would be congruent with Jane's diagnosis? | Binging, purging, normal weight, hypokalemia.
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| A hospitalizes client with Bulimia Nervosa has stopped vomiting in the hospital in the hospital and tells the nurse she is afraid she is going to gain weight. What is the most appropriate response by the nurse? | "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition; but for now I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment."
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| The binging episode is thought to involve: | A release of tension, followed by feelings of depression.
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