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2nd Semester Nursing > Psych Eating Disorders > Flashcards

Flashcards in Psych Eating Disorders Deck (63):
1

What part of the brain regulates appetite?

hypothalamus

2

Primary characteristic of anorexia nervosa

Body image disturbance - belief that they’re fat when they’re obviously very thin.

3

What are the BMI ranges for mild-mod-severe anorexia?

Mild = 17kg
Moderate = 16-16.99
Severe = 15-15.99
Extreme = less than 15

4

How does anorexia affect the family dynamic?

Focus is centered on the anorexic. Other people lose patience or get ignored.

5

Which is more common - bulimia or anorexia nervosa?

Bulimia

6

A binge is how many calories in how much time?

1000 cal in less than 2h

7

DSM V categories for bulimia

Mild: 1-3/wk
Moderate: 4-7/wk
Severe: 8-13/wk
Extreme: 14+/wk

8

Criteria for diagnosis of bulemia?

Binge/compensation 2x weekly for 3+mos

9

What are the compensatory behaviors for bulimia?

Vomiting
Laxatives
Diuretics
Fasting

10

NTs for bulimia vs NTs for anorexia?

Bulimia: Serotonin & norepinephrine

Anorexia: high endogenous opioid levels

11

Binge-eating disorder is characterized by

Large food binges
No attempt to rid the body of excess calories

Eating without hunger
Extremely rapid eating

12

Body Dysmorphic Disorder

Preoccupation with perceived flaws

Repetitive mirror-checking, grooming, skin-picking, comparing appearances

Distress d/t preoccupation

Not explained by concerns about fat/weight.

Not an eating disorder.

13

What kind of food do bulimics and binge-eaters prefer?

Carbohydrates/sweets

14

Possible meds for binge-eating disorder?

Venlafaxine/desfenlafaxine

Topiramate

15

Possible meds for obesity?

Prozac
CNS stimulants
Lorcarserin
Phentermine/topiramate

16

Meds with some success treating anorexia nervosa?

Aripiprazole

Maybe Olanzapine/Risperidone

17

Common themes between eating disorders

Low self-esteem
Fear of maturity
Conflict avoidance
Anxiety

18

What does elder abuse consist of?

Violation of personal rights

Abandonment

Material and financial exploitation

Neglect of care needed

19

Signs/Symptoms of child abuse

Disturbed growth/development

Ambivalence/denial

Sleep/eating disturbances

Bedwetting

Anxiety/depression/aggression

Sexualized play

Unexplained marks/bruises

Frightened of parents

Absence from school

Begs/steals food/money

Dirty, BO, insufficient clothes

saying “no one is home”

Refusing to change for gym

20

ACES predispose you to...

Depression
Anxiety
Substance Abuse
Risk for Suicide
Heart disease
Hypertension

21

What is adjustment disorder?

Maladaptive reaction to a stressor (that can be identified) that affects functioning:

Can be with:
-mood (depression)
-anxiety
(Or both)
-conduct disturbance
-emotional AND conduct disturbance

Happens w/in 3 months of stressor and ends w/in 6 months.

22

Define Acute Stress Disorder

Dissociative symptoms (amnesia, depersonalization, de-realization, numbing, detachment, lack of emotional response) occur during or w/in 4 weeks following event

Last for 2days-4weeks.

(Difference btw ASD and PTSD is onset and duration)

23

Both PTSD and ASD share what symptoms?

-avoidance of feelings/thoughts/people associated with trauma

-intense emotional reactions (fear, horror, helplessness)

-dissociation

-hyperarousal

-re-experiencing of trauma

24

What sorts of events can ASD and PTSD develop after?

One that threatens
-self
-others
-resources
-sense of control
-sense of hope

25

PTSD definition

After 1+months (and lasting for more than 1 month):

-social, interpersonal, occupational functioning are impaired

-person reduces involvement with external world

-goal is avoiding memories of the trauma

26

Arousal symptoms of PTSD - what are they caused by?

Increased noradrenergic and dopaminergic system activity

Decreased serotonergic activity

27

What are PTSD arousal symptoms?

-increased startle
-anxiety
-restlessness
-irritability
-sleep disturbances
-memory/concentration impairment
-anger outbursts
-survivor guilt
-hypervigilance

28

In what ways do PTSD sufferers re-live the flashbacks?

Intrusive memories

Nightmares

Illusions

Flashbacks

29

How is the hippocampus damaged in PTSD sufferers?

From high glucocorticoid levels and prolonged exposure to stress.

Alters stress response, memory and fear conditioning.

30

What causes blunting, physical analgesia and depersonalization in PTSD?

Increased endogenous opiate release

31

What causes the re-experiencing of trauma that PTSD sufferers experience?

Activation of amígdala, locus ceruleus, hypothalamus, thalamus and HPA axis ...

Has to do with memory coding/retrieval

32

Will estrogen and testosterone increase or decrease in PTSD sufferers?

They’ll increase secondary to a down-regulation of corticotrophin-releasing harming release.

33

What are the characteristics of a healthy reorganization process after violence/trauma?

Gradual decrease in anxiety, fear, anger

Starts with review/organization of what happened and why (includes blame and justification)

Progresses to regaining a sense of control and self-protection

Progresses to resolution of grief.

Lasts from months to years.

If resolution doesn’t occur, anything that remains qualifies as PTSD.

34

What are the characteristics of Recoil?

Struggle to adapt

Periods of acting normal

As phase progresses, there’s a desire to talk about details/feelings about trauma.

Need for support and temporary dependence.

Last weeks to months.

Gradual awareness of full impact.

35

What are the goals for treating PTSD?

-reduce symptoms
-improve functioning
-strengthen resilience
-relieve comorbid symptoms
-integrate traumatic experience
-prevent relapse

36

Pharmacology: what would you use to reduce conditioned fear/anxiety?

Benzodiazapines

Maybe Buspirone

37

Pharmacology: what would you use to help diminish the peripheral autonomic response?

Clonidine
Propranolol

38

Pharm: what would you use do decrease hyperarousal, nightmares, mood swings, and explosive outbursts?

Valproic Acid

39

What would you use to decrease repetitive behaviors, images and somatic states?

SSRIs

*specifically
-Paroxetine*
-Sertraline*

40

What are risk factors for experiencing partner abuse?

-Witnessing parental violence

-prior victimization

-early puberty

-early use of drugs/alcohol

-exposure to media/internet violence

41

What are the 4 phases in the cycle of abuse?

1. Tensions building

2. Incident occurs

3. Reconciliation

4. Calm

42

Perpetrator behaviors in the tension-building phase?

-excessive expectations
-blaming
-doesn’t try to control behavior
-doesn’t acknowledge inappropriate behavior
-verbal & minor physical abuse increases
-controlling out of fear that partner will leave
-interprets partner’s withdrawal as rejection

43

What are the victim’s behaviors in the tension-building phase?

-tries to please
-denies seriousness
-thinks they can control abuser’s behaviors
-blames external factors
-thinks they deserve minor abuse
-gets scared, tries to hide
-calls for help if tension becomes unbearable

44

Perpetrator behaviors in serious battering incident?

-Trigger can be internal or external

-occurs in private

-threatens harm if victim tries to get help

-justifies behavior

-minimizes severity of abuse

-this relieves tension for abuser

45

Victim behaviors in a serious battering incident?

-might call for help

-shock, denial, disbelief

-fears more abuse if police arrive or arrest

-anxious, ashamed, humiliated, fatigued, depressed

-does not seek help for a day or more, lies about cause

46

Honeymoon phase, perpetrator behaviors?

-loving, charming, asks for forgiveness

-tells themselves they won’t do it again

-believes they’ve taught victim a lesson and that they won’t “act up” again

-guilt-trips victim to keep them trapped

47

Honeymoon phase victim behaviors?

-thinks loving behaviors are the real person

-wants to believe it won’t happen again

-believes that if they stay, abuser will get help

-feel guilty about considering leaving

-feels trapped in a permanent relationship

48

What interventions would you focus in the Impact stage?

-crisis intervention:

-simple directions
-avoid accusations
-provide physical safety
-provide emotional security
-provide phone number for crisis intervention

49

Interventions in recoil stage?

-Support groups
-Short-term counseling
-validation of victim and their rights
-referrals to therapies/victim groups

50

Interventions in Reorganization stage?

Long-term counseling for anxiety, PTSD, depression

51

What is the biological/psychological source of personality disorders?

There isn’t one that they know of.

52

What’s the difference between cluster A, B, and C (personality disorders)?

A: odd/eccentric
B: dramatic/emotional/erratic
C: Anxious/fearful

53

What cluster does Borderline PD fall into?

Cluster B (dramatic, emotional, erratic)

54

Why are you most likely to see BPD in an inpatient unit?

Self-harm

55

When would you see medication in a personality disorder?

When it is used for a comorbidity - doesn’t treat BPD.

56

What is BPD characterized by?

-instability in relationships

-alternating extremes of idealizing and devaluation

-frantic effort to avoid abandonment/feelings of emptiness

-emotional dysregulation

-transient stress r/t paranoia or dissociation

57

What would Naltrexone be used for in BPD?

Self-harm behaviors

58

What would Lithium, Depakote or Carbamazepine be used for in BPD?

Rapid mood swings

59

What would SSRIs be used for in BPD?

Emotionally dysregulation

60

What would antipsychotics be used for in BPD?

Aggressiveness, violence
Extreme impulsivity

Cognitive-perceptual symptoms (paranoia, etc...)

61

Antisocial Personality Disorder is characterized by...

Disregard for the rights of others from about age 15.

Illegal actions

Deceitful/cons others for pleasure/profit

Irritable, irresponsible, lack of remorse or guilt for behaviors

Impulsivity

Doesn’t assume responsibility for behaviors

Difficulty sustaining employment or maintaining relationships

62

What are risk factors for antisocial personality disorder?

ADHD/disruptive behavior disorder or conduct disorder in childhood

History of severe abuse

Absent/inconsistent discipline

Extreme poverty

Removal from home

Always being rescued when in trouble

Maternal deprivation

63

What are some nursing interventions for antisocial personality disorder?

Consistent limit setting

Fostering responsibility and accepting consequences

Identification of real feelings.