Eating Disorders Flashcards

Question

My therapeutic role in EDs

Answer 1

–Acknowledge complex causation of ED –Acknowledge function of the ED (what it gives that person e.g. safety, control) –Be aware of your emotional reactions * understand these, rather than act on them * Relate rather than control –Expect & tolerate their ambivalence –Explain the rationale for treatment –Repetition - expect that they may forget everything you have said! TIPS: warmth, compassion, empathy, understanding * “I understand your concerns but I must do this to keep you safe.” * “You may not agree with me right now but I am acting in your best interests.” * “I can see that you are scared.” * “I hear what you are saying.” * “Based on what you’ve told me, I can see why you are acting in this way.” * “You may not wish to look after yourself right now yet my job is to look after you.”

Answer 2

* Restrict activity * Correct micronutrients * Deliver calories safely * Correct electrolyte disturbances * Improve weight * Treat psychological disturbance * Control behaviour

Answer 3

•BMI \<13 = sick patient = must improve BMI – likely needs admission –Bed rest –NG feed * BMI \< 14.5 = Concern – need to be vigilant and support * Likely to need 1-2-1 nursing – contact nurse bank

Answer 4

* Aim for BMR plus 500 calories * Start at 35kcal/kg (controversial) * Give pabrinex, thiamine and m-vits * Correct electrolytes BUT also increase feed rate * Aim for 0.5-1.0kg/week weight gain * BUT care with excess exercise – this can burn up many hundreds of calories and therefore mean “needs more food”

Answer 5

•These patients do not have capacity with respect to eating and food therefore the MCA can be used to treat them in their best interests –NG feed etc •Starvation is an EMERGENCY

Answer 6

* Deprivation of liberty * Approved mental health professional (AHMP) - SW, Nurse, OT, Psychologist, Approved by local SS * Relevant sections - 5(2),2 ,3

Answer 7

* Compulsory admission to hospital * Assessment * 28days * Application by AMHP * 2 doctors confirm: Patient has mental disorder that needs admission, needs detaining for own or others safety.

Answer 8

* COmpulsory admisison to hospital * Treatment * Up to 6m * Application by AMHP * 2 doctors confirmed: Patient has mentla disorder that needs admisison, tretment is available in hospital, needs detaining for own or others safety

Answer 9

* “Challenging, exhausting, lonely, miserable” * No one felt it was about weight * Learning from mistakes, keeping going, building confidence, feeling empowered and express emotions in a non-destructive way * Being able to laugh again and enjoy life (and food!), do the things you love * Learning to accept your body; not feeling constantly disgusted and angry with yourself * Finding out and accepting who you are (it’s not all about your appearance) * Managing symptoms and accepting that you won’t necessarily be symptom-free * Not being controlled by the eating disorder

Answer 10

•Affect young people –Peak onset 15-19 F; 10-14 male –62% develop symptoms before age 16; 86% by age 19; 95% by age 24 (BEAT 2015) –Rates increasing. –In girls aged 10-19 years, there are nine times as many new cases of eating disorder (1.2 per 1000 population) diagnosed every year as of type 1 diabetes (Micali 2013) * Increased mortality rate (Arcelus 2011) * Long term physical sequelae –Osteoporosis and increased fracture rate (Lucas 1999) * Impact on social, academic and occupational outcomes (Mond 2014) * Increased suicide risk (Franko 2006) * Economic impact estimated at £15 billion per year (Beat 2015)

Answer 11

* 50% full recovery * 30% partial recovery * 20% chronic illness (Steinhousen 2002) * Recovery rates reduce after 5 years of illness BUT they never drop to zero (Lacey 2015)

Answer 12

•Indicators of good prognosis (Steinhousen2002; Nogel 2009) –Young age –Short duration of illness •Indicators of poor prognosis (Berkman 2009) –Very low BMI –Previous treatment episodes –Psychiatric co morbidity

Eating Disorders Flashcards

(37 cards)