Eating Disorders & Childhood Disorders Flashcards
(18 cards)
What are RN interventions for anorexia ?
- medical stabilization before psychological
- assess for refeeding syndrome
- assess for suicide
- encourage milieu therapy
- self-care education: coping, social skills
- highly structured environment: caloric counting by RN, exact meal times, observation during/after meals, routine weights, possible behavior plan, possible visitor restriction
What is the desired weight gain for anorexia ?
1-2 lbs/week
What are some meds of anorexia ?
no specific meds
- Fluoxetine (Prozac): reduces obsessive-compulsive behaviors
- olanzapine (zyprexa): improves mood and decreased obsessive behaviors and resistance to weight gain
What are some assessments for bulimia ?
- often of normal weight
- enlarged parotid glands
- dental erosion/caries: from vomiting
- bradycardia
- callouses on hand: from vomiting (Russell’s sign)
- BP changes
- cardiac arrhythmia
- electrolyte disturbances
- hypokalemia
- dehydration
- esophageal tears from vomiting
What are some possible meds for bulimia ?
- SSRIs and tricyclics
- fluoxetine: may prevent relapse
- bupropion (wellbutrin): contraindicated in those who purge due to seizure potential
What are RN interventions for binge-eating disorder ?
- assess and tx GI disturbances
- be aware of own stereotypes of obese patients
- assist to create new coping skills
What are some meds of binge-eating disorder ?
- SSIRs, tricyclic, anticonvulsants, appetite suppressants
- diet pills: cardiac effects but benefit may outweigh risk
- Lorcaserin (Belviq): helps pt feel full after eating, blocks appetite signals
What is rumination ?
regurgitation with rechewing, reswallowing or spitting
- no medical or mental reason
What is dysgraphia ?
difficulty with written expression
What are interventions for Autism ?
- assess for developmental delays
- provide structure and consistency in rules and expectations at home
- SSRIs effective for improving mood and decreasing anxiety
- may use atypical antipsychotics for harmful behavior
What are characteristics of ADHD ?
- impulsiveness, inattention, over activity and recklessness
- symptoms must be present in 2 settings and occur before age 12
What are interventions for ADHD ?
- provide low-stim areas for work requiring concentration and focus
- maintain consistent schedule and set clear limits
- rewards positive and expected behaviors
- teach techniques to improve impulse control
What is bibliotherapy ?
using literature to help children express feelings in a supportive environment
- gain insight into feelings and behavior
- learn new ways to cope
What are characteristics of stimulants ?
- may worsen other psychiatric disorders if not prescribed correctly
- SE: insomnia, appetite suppression, weight loss, tics, slight increase in BP and HR, HA, Abd pain, lethargy
- specific admin guidelines
- some evidence to support delayed growth in kids
What are examples of central nervous stimulants ?
- Methylphenidate (Ritalin) (most frequent and 1st line tx),
- Daytrana (transdermal),
- Dextroamphetamine
- Amphetamine Salts (Adderall)
- Vyvanse
(Non-stimulant=Strattera)
What is oppositional defiant disorder ?
persistent angry, irritable, and negative mood
- defiant and vindictive behavior (will get revenge)
- blames others for behavior
- some kids may outgrow but can progress to conductive disorder
- social difficulties, academic issues, conflicts with authority figures
What is intermittent explosive disorder ?
inability to control aggressive impulses
- adults 18 yrs or older
- level of anger out of proportion to situation
- outbursts, unable to control aggressive impulses
- pattern of aggression and remorse
- interpersonal, occupational and criminal difficulties
What is conduct disorder ?
behavior is usually abnormally aggressive
- rights of others are violated and societal norms or rules are disregarded
- lack of remorse
- juvenile court involvement & delinquency
- child onset (<10 yrs) & adolescent (>10 yrs)
- pyromania (obsessed with fire) & kleptomania (stealing)
- 2nd gen antipsychotics
