Unit 11 Flashcards
What are s/s of anorexia nervosa?
Intense fear of weight gain
Distorted body image
Restricted calories with significantly low BMI
Perfectionism
Yellow skin
Cold extremitites
Peripheral edema
What are s/s of bulimia nervosa?
At or near body weight
Enlarged parotid glands
Dental erosion
Impulsive
What are s/s of binge-eating disorders?
Uncontrollable binging without compensatory behavior
Guilt, depression, embarrassment, or disgust often accompanies people.
What is the nursing process for anorexia nervosa?
Assessment: perception of problem, eating habits, mental status?
Diagnoses: imbalanced nutrition, decreased cardiac output, risk for injury due to electrolyte imbalance and fluid imbalance
Outcomes: identify
Planning: refeeding syndrome (too high of caloric intake too fast)
What is the nursing process for bulimia nervosa?
Look for stability in relationships
Give acute care: teamwork, safety, medication, counseling, and health teaching/promotion
May try psychotherapy
What is the nursing process for binge-eating disorders?
The most common disorder runs in families
Assess for gastrointestinal problems (heartburn, dysphagia, bloating, abdominal pain, diarrhea, urgency, constipation, and feelings of anal blockage)
Interventions: psychotherapy, bariatric surgery, teamwork/safety, health teaching/promoting, medications.
What is the risk factors of eating disorders?
Binge-eating: This could be caused by sexual abuse, social pressure, or low self-esteem
Bulimia Nervosa: Non-nurturing family relationships, familial/social instability, difficult interpersonal relationships, impulsivity and compulsivity
What are realistic outcomes for a patient with an eating disorder?
Maintain their mental status, while creating a better relationship with food.
Higher self-esteem
What are s/s of disruptive mood dysregulation disorder?
Constant/severe irritability and anger, commonly expressed in outbursts
Onset before age 10, diagnosis between 6-18yrs old
3x a week outbursts
What are treatments of disruptive mood dysregulation disorder?
Focused on symptoms
IF it resembles depression antidepressants may be considered
Risperidone (2nd gen antipsychotics) for irritability
CBT
What are s/s of persistent depressive disorder (dysthymia)?
low-level depression occurs most of the day for the majority of the days
Decreased appetite or overeating
Insomnia or Hypersomnia
Low energy
Low self-esteem
Difficulty thinking
Hopelessness
What are s/s of premenstrual dysphoric disorder?
Mood swings
Irritability
Depression
Anxiety
Feeling overwhelmed
Difficulty concentration
Breast tenderness
Bloating
Lack of energy
Decrease significantly or disappear with the onset of menstruation
What are treatment of premenstrual dysphoric disorder?
Regular exercise
Eating food with carbs
Sleeping enough
Acupuncture
Light therapy
Relaxation therapy
Meds: contraceptives, SSRIs, and diuretics (bloating and weight gain)
What is ECT?
Approved for depressive symptoms
Assess for HTN, CHF, arrhythmias, and cardiac conditions; brain tumors and subdural hematomas
Procedure: given anesthetic, discontinue benzos, brief seizures are deliberately induced by an electrical current
2-3x a week for a total of 6-12 treatments
What is TMS?
Magnetic pulses to stimulate focal areas of the cerebral cortex for mild treatment-resistant depression
CI: metal, seizures (using high-frequency TMS)
30 minutes for 5x a week for 4-6 weeks
May feel pain on scalp
What is DBS?
Electrodes are surgically implanted into specific areas of the brain to stimulate those regions.
Risks: hemorrhage, seizures, stroke, confusion, and headache.
May cause hypomania
What are the s/s of major depressive disorder?
5 or more:
- weight loss
- fatigue
- sleep disturbances
- worthlessness
- loss of ability to concentrate
- recurrent thoughts of death
- restlessness observed by others
1 of the following:
- depressed mood
- loss of interest or pleasure (anhedonia)
What are the origins of major depressive disorder?
Persistently depressed mood lasting for a minimum of 2 weeks to 6 months, often recurring.
Chronic: lasts more than 2 years
No manic or hypomanic
What is affect, thought processes, mood, feelings, and physical behavior?
Affect: outward representation of a person’s internal state
Thought processes: slow or absent, may be in poverty of thought
Mood: describes a general emotional condition or state
Feelings: more specific and can come and go quickly when compared to mood
What are s/s of bipolar 1 and 2 and cyclothymic disorder?
Bipolar 1: more common in males most severe, at least 1 manic episode that last longer than 1 week; starts with a beautiful high; wont diagnose children
Bipolar 2: more common in females 1 hypomanic that lasts 4 days, no psychosis; 1 major depressive episode
Cyclothymic: more common in teens and YAs alternate with symptoms of mild to moderate depression for at least 2 years in adults and 1 year in children; rapid cycling possible
What is mania?
Manipulative, demanding, splitting
Last for 1+ weeks
Low eating and sleeping
Risk-taking
Psychotic (hallucinations, delusions, disturbed thoughts)
What is hypomania?
A lower form of mania, high functioning
What are the communication methods and care plans for mental illness patients?
Make observations
Simple, concrete words
Allow time for a response
Ask about suicide
What do I need to know about lithium?
Below 1.5: n/v/d, thirst, polyuria, sedation, fine hand tremor
1.5-2.0: GI upset, coarse hand tremor, incoordination
2.0-2.5: ataxia, giddiness, blurred vision, seizures, hypotension, coma
>2.5: convulsions, oliguria, death
CI: cardiovascular disease, brain damage, renal disease, thyroid disease, myasthenia gravis
