Exam 2 Flashcards
What is PICA?
people eating non-edible usually due to the body saying they have a nutritional deficiency
What is rumination disorder?
highly focused on food with frequent vomiting and slow chewing
they are still eating so it’s not anorexia and they are not forcing themselves to vomit so it’s not bulimia
What is avoidant restrictive food intake disorder?
selective and restrictive safe foods
What is bulimia nervosa?
voluntarily vomiting to avoid the body from processing calories
What are the risk factors for anorexia nervosa?
OCD, type A, low self-esteem
family dynamics, life changes, social media, occupation
increased risk among first degree relatives
most common in countries such as US, australia, new zealand, japan
What is refeeding syndrome? Prevention?
electrolyte levels drop even lower as patients begin receiving more calories/reintroducing food
in cases of severe malnutrition K, Mg, and P are already low. once the body starts to eat again and re-secreting insulin electrolytes shift into the cells causing serum levels to drop
increase calories slowly, monitor values and replace as needed
What is the treatment plan for patients with anorexia nervosa?
avoid trigger words: food, calories, weight
focus on words: medicine, nourishment, energy
collaboration with family: share success, struggle will fade, there is medical harm if not treated properly
strict bedrest with bathroom privileges, activity progress slowly as orthostatic VS and labs improve
can be vegetarian or dairy free, but not vegan
start with 2000 kcal/day and increase 200-400 kcal/day
eventual weight gain of 0.8kg per week, mild weight loss and plateau may occur during early refeeding stage
What is wernicke encephalopathy syndrome? Classic triad? Seen typically with?
neurologic complication due to thiamine deficiency
gait ataxia (d/t neurological and vestibular dysfunction), encephalopathy (profound disorientation, indifference in attentiveness, impaired memory and learning, agitated delirium, stupor, coma, death), oculomotor dysfunction (eye: nystagmus, pupillary abnormalities)
alcoholism, poor dietary intake, increased metabolic requirements, increased loss of water-soluble vitamins
What are physical symptoms of alcohol withdrawal at certain time points?
6 to 36hrs: minor withdrawal: tremulousness, mild anxiety, headache, diaphoresis, palpitations, anorexia, GI upset, normal mental status
6 to 48hrs: seizures: single or brief flurry of general tonic-clonic seizures,
12 to 48hrs: alcoholic hallucinations: visual, auditory, and/or tactile hallucinations with intact orientation and normal vitals signs
48 to 96hrs: delirium tremens: delirium, agitation, tachycardia, HTN, fever, diaphoresis
What is symptom triggered thearpy?
provide medication only when a patient is having a symptom versus maintenance dosage
What CIWA score indicates need for medical intervention?
> 8
What is the purpose of medications for AUD? What are examples?
prevent minor withdrawal symptoms becoming major ones
diazepam: preferred d/t smoother clinical course with lower chance of reocurrance withdrawal or seizures
lorazepam: short half life compared to librium (the longer the half life the increased chance of over sedation and increased complications)
librium: preferred d/t smoother clinical course with lower chance of reoccurrence withdrawal or seizures
What is neonatal abstinence syndrome? Clinical manifestations?
intrauterine drug exposure that can cause abnormalities
hyperactivity of central and autonomic nervous system and GI tract
common characteristics: high-pitched cry, shrill, inconsolable, irritability, tremors, difficulty feeding, tachypnea
alterations in sleep/wake cycle, alterations in tone and movements, sweating, sneezing, fever, nasal stuffiness, frequent yawning
GI: loose stools, gassy, vomiting
long-term complications: cognitive impairments, cerebral palsy, attention deficit disorder, language abnormalities, severe microcephaly, delayed growth
What are responsibilities of a forensic nurse?
crisis management
independent medical screening of a patient who has been assaulted and identification of injuries
exposure risks for STIs and pregnancies and prophylaxis
evidence collection and preservation
medically indicated forensic photography
collaboration with community agencies, such as advocates, law enforcement and the criminal justice system
court testimony
What are the stages of intimate partner violence?
honeymoon: attentive, caring, loving
tension building: things begin to become tense, starts fights and yells at you for no reason, feels like you can’t do anything right and that things could blow up at any moment
explosion: outburst of violence that can include intense emotional, verbal, sexual and/or physical abuse. abuser may: physically abuse, scream and yell in a way that scares or humiliates, rape or force sexual contact, threaten to hurt
