Eating Disorders

Question 1

Causes/Risk Factors: Genetics

Answer 1

Fx of bulimia nervosa, mood disorders, substance use disorders, or obesity

Question 2

Risk factors for anorexia

Answer 2

Female adolescent

Question 3

Risk factors for bulimia nervosa

Answer 3

2% among women in late adolescence or early adulthood

Question 4

Psychological factors that cause eating disorders

Answer 4

Unfulfilled sense of separation
Threaten vulnerable ego, feeling of lack of control over one’s body
OCD: obsessed with food

Question 5

Social influences that cause eating disorders

Answer 5

Peer pressure, ballet training/wrestling sports, media

Question 6

Definition of anorexia nervosa

Answer 6

Morbid fear of obesity, weight loss is excessive, less than 85% of expected weight

Question 7

Anorexia nervosa
Restricting type

Answer 7

During the last 3 months, the pt hasn’t had episodes of binge eating or purging

Question 8

Anorexia Nervosa
Binge-eating/Purging type

Answer 8

During the last 3 months, pt engages in recurrent episodes of binge eating or purging behavior

Question 9

Medical S&S of anorexia nervosa

Answer 9

hypothermia, bradycardia, orthostatic hypotension, peripheral edema, and lanugo, and a variety of metabolic changes, dizziness, pain and discomfort, constipation, weakness, amenorrhea

Question 10

S&S of anorexia nervosa

Answer 10

Gross distortion of body image
Refusal to eat
Obsessed with food
Compulsive behaviors
Depression and anxiety

Question 11

Diagnosis of Anorexia nervosa

Answer 11

Restriction of energy intake leading to significant low body weight
Intense fear of gaining weight/becoming fat
Lack of recognition of seriousness of current low body weight

Question 12

Severity of Anorexia nervosa

Answer 12

Mild: BMI > 17
Moderate: BMI 16-16.99
Severe: BMI 15-15.99
Extreme: BMI < 15

Question 13

Treatment of anorexia nervosa

Answer 13

Slowly give food in increments, minimize focus on food, pocketing food, individual and family psychotherapy

Question 14

Nursing interventions for anorexia nervosa

Answer 14

Alternative feedings, monitor labs, minimize focus on food, monitor I&O, monitor weight, close supervision during and after meals, collaborate with dietary staff

Question 15

What is refeeding syndrome?

Answer 15

medical complications that result from fluid and electrolyte shifts as a result of aggressive nutritional rehabilitation.

Question 16

Definition of bulimia nervosa

Answer 16

Episodic, uncontrolled, rapid ingestion of large amounts of food over a short period, followed by inappropriate compensatory behaviors

Question 17

Complications of bulimia nervosa

Answer 17

Heartburn, insomnia, depression and anxiety, dehydration, fluid electrolyte imbalances, gastric rupture

Question 18

Comorbidity of bulimia nervosa

Answer 18

mood disorders, anxiety disorders, or substance abuse
CNS stimulants or alcohol

Question 19

S&S of bulimia nervosa

Answer 19

Weight fluctuations
Excessive concern with personal appearance: how others perceive them
Excessive vomiting and laxative or diuretic abuse
Erosion of tooth enamel
Tears in the gastric or esophageal mucosa
Calluses on the dorsal surface of their hands (Russell’s sign)

Question 20

Diagnosis of bulimia nervosa

Answer 20

Recurrent episodes of binge eating
Binge eating and inappropriate compensatory behaviors occur at least once a week for 3 months

Question 21

Severity levels of bulimia nervosa

Answer 21

Mild An average of 1-3 episodes per week
Moderate: An average of 4-7 episodes per week
Severe: An average of 8-13 episodes per week
Extreme: An average of 14 or more episodes of per week

Question 22

Treatment of bulimia nervosa

Answer 22

Triggers, mood and family therapy, dietitian, dietary requirements: well balanced diet, SSRI for depression, hospitalized

Question 23

Nursing interventions for bulimia nervosa

Answer 23

supervised at meal time, set a time limit for eating, food journal, helping to relieve stress, patient and family education. Always include family in treatment

Question 24

Definition of binge eating disorder

Answer 24

Episodes of binge eating with absence of compensatory purging = risk of substantial weight gain
Occur over a discrete period, less than 2 hours. Eating is out of control

Question 25

Triggers of binge eating disorder

Answer 25

interpersonal stressors, low self-esteem, and boredom

Question 26

Medical complications of binge eating disorder

Answer 26

diabetes, cardiac disease, hyperlipidemia, gallbladder disease, hypertension

Question 27

S&S of binge eating disorder

Answer 27

Constantly thinking about food Higher risk of substance abuse Eating every 2 hours

Question 28

Diagnosis of binge eating disorder

Answer 28

Eating in a discrete period of time No use of inappropriate compensatory behaviors

Question 29

Severity of binge eating

Answer 29

Mild: 1-3 binge-eating episodes per week Moderate: 4-7 binge-eating episodes per week Severe: 8-13 binge-eating episodes per week Extreme: 14 or more binge-eating episodes per week

Question 30

Treatment/Nursing intervention of binge eating

Answer 30

psychotherapy (what is the underlying causes), therapeutic relationship, food journaling, thyroid problems

Question 31

Family and client education regarding eating disorders

Answer 31

Principles of nutrition Ways pt may feel in control of life Importance of expressing fears and feelings Alternative coping strategies Medication Education Relaxation techniques Problem solving-techniques Maudsley approach

Question 32

Special education for the obese patient

Answer 32

How to plan a reduced-calories, nutritious diet How to read food content labels How to establish a realistic weight lost plan How to establish a planned program of physical activity

Question 33

Maudsley approach

Answer 33

Phase 1: focused on weight restoration Parents are actively engaged in establishing the rules and guidelines around eating Move onto phase II when pt accepts parental demands for > food intake and demonstrates steady weight gain, and change in mood Phase II: control of maintaining weight gain is returned to the adolescent Move to phase III if able to maintain > 95% of ideal weight Phase III: develop a health self-identity: incorporating CBT and DBT skills