T3 - Eating Disorders (Josh)

Question 1

Types of Eating Disorders

Answer 1

Anorexia Nervosa

Bulimia Nervosa

Obesity

Binge-Eating Disorder (BED)

Question 2

The appetite regulation center of the brain is in the —

Answer 2

hypothalamus

Question 3

Anorexia Nervosa affects approximately – of young women and is predominent in ages –

Answer 3

1%

12-30 yrs

Question 4

Which is more prevalent, Bulimia Nervosa or Anorexia Nervosa?

Answer 4

Bulimia Nervosa (4%)

Question 5

The onset of bulimia nervosa occurs when?

Answer 5

late adolescence

early adulthood

Question 6

Obesity is BMI of

Answer 6

30 or greater

Question 7

What percentage Adult Americans are overweight?

Answer 7

68. 5%

* 35% are obese

Question 8

With Anorexia the client is – with food

Answer 8

preoccupied and obsessed

Question 9

Clinical Anorexia is – below their ideal weight.

Answer 9

15% or more

Question 10

S/S of Anorexia:

Answer 10

• 15% OR MORE UNDER IDEAL WT.
• EMACIATED
• HYPOTHERMIA
• BRADYCARDIA
• HYPOTENSION
• EDEMA
• LANUGO
• DRY, BRITTLE HAIR
• AMENORRHEA
• YELLOW SKIN
• CONSTIPATION
• HEART FAILURE
• ABNORMAL LABS
• ELECTROLYTE IMBALANCE
• MUSCLE WEAKNESS

Question 11

Which is characteristic of the diagnosis of anorexia nervosa?

a) Obsession with weight gain
b) Body image disturbance
c) Disregard for the feelings of others
d) Healthy family relationships

Answer 11

b) Body image disturbance

Question 12

Bulimia is characterized by – followed by —-

Answer 12

binging

purging

Question 13

Bulimia s/s

Answer 13

• BINGING FOLLOWED BY PURGING
• MAY RID BODY OF EXCESS CALORIES BY SELF-INDUCED VOMITING
• MAY MISUSE LAXATIVES, DIURETICS, ENEMAS
• FASTING OR EXCESSIVE EXERCISE
• NORMAL WT OR SLIGHTLY UNDER OR OVER
• DEPRESSION, ANXIETY, SUBSTANCE ABUSE ARE COMORBID

Question 14

Callouses on hands are a sign of —

Answer 14

bulimia

Question 15

Peripheral edema is a sign of —

Answer 15

bulimia

Question 16

Parotid edema is a sign of –

Answer 16

bulimia

Question 17

What happens to teeth w/ Bulimia?

Answer 17

dental erosion

Question 18

Which assessment finding would the nurse expect in clients diagnosed with bulimia? They:

a) are below normal weight.
b) binge when they experience hunger.
c) will be highly motivated to seek help.
d) are within their normal weight range.

Answer 18

d) are within their normal weight range.

- Clients diagnosed with bulimia nervosa are often able to maintain a normal weight by purging after binging.

Question 19

Calculate BMI:

Answer 19

WT in kg divided by HT in Meters squared

Question 20

How does Binge Eating Disorder (BED) differ from Bulimia?

Answer 20

In BED, the individual does not engage in behaviors to rid the body of the excess calories.

Question 21

Which eating disorder can lead to Obesity?

Answer 21

BED (Binge Eating Disorder)

Question 22

A client is 5’8’’ tall and weighs 105 pounds. The client has been taking laxatives daily, an self-induces vomiting after eating. Which is the priority nursing diagnosis for this client?

a) Ineffective denial
b) Disturbed body image
c) Low self-esteem
d) Imbalanced nutrition: less than body requirements

Answer 22

d) Imbalanced nutrition: less than body requirements

Question 23

In planning to treat eating disorder, what is the goal?

Answer 23

normalize eating habits

Question 24

What is a realistic weight gain goal for anorexia?

Answer 24

2-3 lbs / wk

Question 25

When should the client be weighed?

Answer 25

daily early in AM after voiding

Question 26

What should we do after meals?

Answer 26

stay w/ client 30 mins to 1 hr after meal

Question 27

Limit or promote exercise w/ Anorexia?

Answer 27

Limit

Question 28

Should we argue or bargain w/ the client w/ an eating disorder?

Answer 28

no

Question 29

Treatment modalities for Eating Disorder

Answer 29

BEHAVIOR MODIFICATION MILIEU GROUP INDIVIDUAL FAMILY PSYCHOPHARMACOLOGY

Question 30

Ways to promote Cognitive-Behavioral Therapies

Answer 30

Cognitive Reframing Relaxation Techniques Journal Writing Desensitization Exercises

Question 31

A nurse is preparing to obtain a nursing history from a client who has a new diagnosis of anorexia nervosa. Which of the following questions are appropriate for the nurse to include in the assessment? A. “What is your relationship like with your family?” B. “Why do you want to lose weight?” C. “Would you describe your current eating habits?” D. “At what weight do you believe you will look better?” E. “Can you discuss your feelings about your appearance?”

Answer 31

A. “What is your relationship like with your family?” C. “Would you describe your current eating habits?” E. “Can you discuss your feelings about your appearance?”

Question 32

Some obese individuals take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated w/ the use of amphetamines that makes this practice undesirable? a) Bradycardia b) Amenorrhea c) Tolerance d) Convulsions

Answer 32

c) Tolerance

Question 33

Psychoanalytically, the theory of obesity relates to the individual's unconscious equation of food w/ a) Nurturing and caring b) Power and control c) Autonomy and emotional growth d) Strength and endurance

Answer 33

a) Nurturing and caring

Question 34

Which of the following physical manifestations would you expect to assess in a client suffering from anorexia nervosa? a) Tachycardia, HTN, hyperthermia b) Bradycardia, HTN, hyperthermia c) Bradycarda, hypotension, hypothermia d) Tachycardia, hypotension, hypothermia

Answer 34

c) Bradycarda, hypotension, hypothermia

Question 35

What will the face of Bulimia client look like?

Answer 35

chipmunk cheeks - due to parotid edema where the food particles block the parotid glands in mouth

Question 36

What will finger of Bulimia client look like?

Answer 36

scars and callouses from the stomach acid

Question 37

When you vomit, what do you lose?

Answer 37

Na Cl

Question 38

Nurse Jones is caring for a client who has been hospitalized w/ anorexia nervosa and is severely malnourished. The client continues to refuse to eat. What is the most appopriate response by the nurse? a) You know if you don't eat, you will die. b) If you continue to refuse to take food orally, you will be fed through a NG tube. c) You might as well leave if you are not going to follow your therapy regime. d) You don't have to eat if you don't want to. It is your choice.

Answer 38

b) If you continue to refuse to take food orally, you will be fed through a NG tube.

Question 39

Which of the following medications has been used w/ some success in clients w/ anorexia nervosa? a) lorcaserin b) diazepam c) fluoxetine d) carbamazepine

Answer 39

c) fluoxetine

Question 40

Jane is hospitalized on the psych unit w/ Bulimia. Which of the following symptoms would be congruent w/ the diagnosis? a) Binging, purging, obesity, hyperkalemia b) Binging, purging, normal weight, hypokalemia c) Binging, laxative abuse, amenhorria, severe weight loss d) Binging, purging, severe weight loss, hyperkalemia

Answer 40

b) Binging, purging, normal weight, hypokalemia

Question 41

The binging episode is thought to involve: a) A release of tension, followed by feelings of depression b) Feelings of fear, followed by feelings of relief c) Unmet dependency needs and a way to gain attention d) Feelings of euphoria, excitement, and self-gratification

Answer 41

a) A release of tension, followed by feelings of depression

Question 42

Concern w/ Refeeding Syndrome.

Answer 42

do it in small increments or you can overload their bodies ability to compensate and they could die

Question 43

What is the effective dosage for fluoxetine for overweight clients?

Answer 43

60 mg/day

Question 44

How does fluoxetine work to treat BED?

Answer 44

SSRI - decreases cravings for carbs, thereby deceasing the incidence of binge eating

Question 45

Drugs shown to work for BED

Answer 45

``` fluoxetine (SSRI) imipramine nortryptaline amitriptyline phenelzine ```

Question 46

Drugs that help w/ the comorbid depression associated w/ anorexia?

Answer 46

SSRIs - fluoxetine - sertraline