CHAPTER 18 Feeding, Eating, and Elimination Disorders Flashcards
(30 cards)
Chapter Review
- While on an inpatient unit, you are caring for newly admitted Alyssa, a 16-year-old diagnosed with anorexia nervosa. Number the following nursing interventions in order of priority:
a. ___ Initiate a therapeutic relationship.
b. ___ Promote caloric consumption.
c. ___ Assess for suicidal ideation
d. ___ Review accomplishments made during treatment.
e. ___ Explore feelings of underlying anxiety and low self-esteem.
1: a. Initiate a therapeutic relationship.
2: c. Assess for suicidal ideation
3: b. Promote caloric consumption.
4: e. Explore feelings of underlying anxiety and low self-esteem.
5: d. Review accomplishments made during treatment.
Chapter 18 Feeding, eating, and elimination disorders
Chapter Review
- Brittany is caring for a patient with bulimia. She recognizes which of the following nursing interventions as being most appropriate?
a. Monitor the patient on bathroom trips after eating.
b. Allow the patient extensive private time with family members.
c. Provide meals whenever the patient requests them.
d. Encourage the patient to select foods that she likes.
a. Monitor the patient on bathroom trips after eating.
Chapter 18 Feeding, eating, and elimination disorders
Chapter Review
- The nurse is admitting a patient who weighs 100 pounds, is 66 inches tall, and is below ideal body weight. The patient’s blood pressure is 130/80 mm Hg, pulse is 72 beats per minute, potassium is 2.5 mmol/L, and ECG is abnormal. Her teeth enamel is eroded, her hands are shaking, and her parotid gland is enlarged. The patient states, “I am really nervous about coming to this unit.” What is the priority nursing diagnosis?
a. Powerlessness
b. Risk for injury
c. Imbalanced nutrition: Less than body requirements
d. Anxiety
c. Imbalanced nutrition: Less than body requirements
Chapter 18 Feeding, eating, and elimination disorders
Chapter Review
- The nurse is planning care for a patient with a binge eating disorder. What outcomes are appropriate? Select all that apply.
a. The patient will identify stressors that lead to binge eating.
b. The patient will identify four alternate coping skills.
c. The patient will increase dietary intake.
d. The patient will experience satisfaction in eating alone.
a. The patient will identify stressors that lead to binge
Chapter 18 Feeding, eating, and elimination disorders
Chapter Revieweating.
- Which of the following are true regarding feeding disorders in children? Select all that apply.
a. Feeding disorders usually reflect poor parenting.
b. Feeding disorders are often manifested in children with developmental delays.
c. Feeding disorders are most often treated with a punishment system.
d. In many cases, toddler mealtime difficulties spontaneously resolve with no intervention.
e. Behavior modification has been found to be effective in treating feeding disorders.
b. Feeding disorders are often manifested in children with developmental delays.
d. In many cases, toddler mealtime difficulties spontaneously resolve with no intervention.
e. Behavior modification has been found to be effective in treating feeding disorders.
Chapter 18 Feeding, eating, and elimination disorders
Chapter Review
- A client has been hospitalized with anorexia nervosa. The client’s weight is 65% of normal. For this client, a realistic short-term goal for the first week of hospitalization would be: By the end of week 1, the client will
a. gain a maximum of 3 lb.
b. develop a pattern of normal eating behavior.
c. discuss fears and feelings about gaining weight.
d. verbalize awareness of the sensation of hunger.
a. gain a maximum of 3 lb.
The critical outcome during hospitalization for anorexia nervosa is weight gain. A maximum of 3 pounds weekly is considered sufficient initially. Too-rapid weight gain can cause pulmonary edema.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Pre-Test
- A subjective symptom the nurse would expect to note during assessment of a client with anorexia nervosa is
a. lanugo.
b. hypotension.
c. 25-lb weight loss.
d. fear of gaining weight.
d. fear of gaining weight.
Option D is the only subjective data listed, and it is universally true.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Pre-Test
- A client with bulimia nervosa uses enemas and laxatives to purge to maintain her weight. The imbalance for which the nurse should assess is a(n)
a. increase in the red blood cell count.
b. disruption of the fluid and electrolyte balance.
c. elevated serum potassium level.
d. elevated serum sodium level.
b. disruption of the fluid and electrolyte balance.
Disruption of the fluid and electrolyte balance is usually the result of excessive use of enemas and laxatives.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Pre-Test
- A coping mechanism used excessively by clients with anorexia nervosa is
a. denial.
b. humor.
c. altruism.
d. projection.
a. denial.
Denial of excessive thinness is the mainstay of the client with anorexia nervosa.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Pre-Test
- Bupropion (Wellbutrin), although seemingly effective, is contraindicated in patients who purge because of
a. historically poor patient compliance.
b. an increased risk of seizures.
c. the long-term effects on liver function.
d. the potential to cause gastric ulcers.
b. an increased risk of seizures.
Bupropion (Wellbutrin), although seemingly effective, is contraindicated in patients who purge because of an increased risk of seizures.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Pre-Test
- A client who is 16 years old, 5 foot, 3 inches tall, and weighs 80 pounds eats one tiny meal daily and engages in a rigorous exercise program. The nursing diagnosis for this client would be
a. death anxiety.
b. ineffective denial.
c. disturbed sensory perception.
d. imbalanced nutrition: less than body requirements.
d. imbalanced nutrition: less than body requirements.
A body weight of 80 pounds for a 16-year-old who is 5 foot, 3 inches tall is ample evidence of this diagnosis.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Pre-Test
- The client with bulimia differs from the client with anorexia nervosa by
a. maintaining a normal weight.
b. holding a distorted body image.
c. doing more rigorous exercising.
d. purging to keep weight down.
a. maintaining a normal weight.
Many bulimics are at or near normal weight, whereas clients with anorexia nervosa are underweight.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Pre-Test
*** 8. A client reveals that she induces vomiting as often as a dozen times a day. The nurse would expect assessment findings to reveal
a. tachycardia.
b. hypokalemia.
c. hypercalcemia.
d. hypolipidemia.
b. hypokalemia.
Vomiting causes loss of potassium, leading to hypokalemia.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Pre-Test
Jeff E.
- During assessment of a client with anorexia nervosa, it is not likely that the nurse would note indications of
a. introversion.
b. social isolation.
c. high self-esteem.
d. obsessive-compulsive tendencies.
c. high self-esteem.
Most clients with eating disorders have low self-esteem.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Pre-Test
- Biological theorists suggest that the cause of eating disorders may be
a. normal weight phobia.
b. body image disturbance.
c. serotonin imbalance.
d. dopamine excess.
c. serotonin imbalance.
The selective serotonin reuptake inhibitors have been shown to improve the rate of weight gain and reduce the occurrence of relapse.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Pre-Test
- Which intervention would be least useful for accurate assessment of the weight of a client diagnosed with anorexia nervosa?
a. Weigh two times daily, then three times weekly.
b. Weigh fully clothed before breakfast.
c. Do not reweigh client when client requests.
d. Permit no oral intake before weighing.
b. Weigh fully clothed before breakfast.
Clients should be weighed wearing only bra and panties before ingesting any food or fluids in the morning.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Post-Test
- Assessment of a client suspected of experiencing bulimia nervosa calls for the nurse to perform
a. a range of motion assessment.
b. inspection of body cavities.
c. inspection of the oral cavity.
d. body fat analysis.
c. inspection of the oral cavity.
Repeated vomiting often causes dental erosions and caries.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Post-Test
- A focus for the acute phase of treatment for anorexia nervosa would be
a. weight restoration.
b. improving interpersonal skills.
c. learning effective coping methods.
d. changing family interaction patterns.
a. weight restoration.
Weight restoration is the priority goal of treatment for the client with anorexia nervosa because health is seriously threatened by the underweight status.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Post-Test
- In contrast to the client diagnosed with anorexia nervosa, the client diagnosed with bulimia usually
a. uses greater denial.
b. is aware of the eating problem.
c. fits more easily into the family.
d. appraises his or her body more realistically.
c. fits more easily into the family.
There is less family concern about the client with bulimia because these clients appear physically normal, the weight is at or near normal, they eat with the family, and the purging is done in secret. The anorexic client is noticed by the family for painful thinness and poor food intake.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Post-Test
- Which statement is least likely to be made by a client diagnosed with bulimia nervosa during the assessment interview?
a. “I eat three meals each day and purge every evening.”
b. “I’m concerned about what others think about my binging and purging.”
c. “I feel as though my eating and purging are out of my control.”
d. “When I eat I feel calm, but then I realize I have to make myself vomit or gain weight.”
a. “I eat three meals each day and purge every evening.”
Most clients with bulimia purge after each meal.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Post-Test
- The nurse working with clients diagnosed with eating disorders can help families develop effective coping mechanisms by
a. teaching the family about the disorder and the client’s behaviors.
b. stressing the need to suppress overt conflict within the family.
c. urging the family to demonstrate greater caring for the client.
d. encouraging the family to use their usual social behaviors at meals.
a. teaching the family about the disorder and the client’s behaviors.
Families need information about specific eating disorders and the behaviors often seen in clients with these disorders. This information can serve as a basis for additional learning about how to support the family member.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Post-Test
- Which assessment question should be asked of a client suspected of demonstrating characteristics of anorexia nervosa?
a. “Do you find yourself feeling hungry?”
b. “How would you describe your body?”
c. “How often do you force yourself to vomit?”
d. “Why do you choose to take laxatives?”
b. “How would you describe your body?”
This question will reveal the cognitive distortion consistent with anorexia nervosa. Invariably the client will describe self as fat despite being excessively underweight.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Post-Test
*** 8. Which diagnosis from the list below would be given priority for a client diagnosed with bulimia nervosa ?
a. Disturbed body image
b. Chronic low self-esteem
c. Risk for injury: electrolyte imbalance
d. Ineffective coping: impulsive responses to problems
c. Risk for injury: electrolyte imbalance
The client who engages in purging and excessive use of laxatives and enemas is at risk for metabolic acidosis from bicarbonate loss.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Post-Test
Jeff E.
- Which intervention would be removed from the plan of care for a client diagnosed with bulimia nervosa?
a. Teach that fasting sets one up to binge eat.
b. Assist client to identify trigger foods.
c. Support importance of avoiding forbidden foods.
d. Teach client to plan and eat regularly scheduled meals.
c. Support importance of avoiding forbidden foods.
No foods should be considered forbidden foods. This issue may be a focus of cognitive behavioral therapy.
Chapter 18 Feeding, eating, and elimination disorders
EVOLVE Post-Test
