week 6 notes

Question 1

manifestations of anorexia nervosa

Answer 1

patches of hair loss on scalp
decreased vitals
anemia
constipation

Question 2

a nurse is reviewing the lab results of a client who has bulimia nervosa. which of the following results should the nurse expect ?

1. elevated potassium levels
2. elevated thyroid hormone levels
3. elevated sodium levels
4. elevated pancreatic enzyme levels

Answer 2

4. elevated pancreatic enzyme levels

*everything else is decreased

Question 3

anorexia nervosa

Answer 3

self-induced restriction of nutritional intake leading to a significantly lower than normal body weight accompanied w distorted body image & fear of being fat

*rituals – tiny pieces, no food touching

Question 4

Bulimia nervosa

Answer 4

BINGEING on large amounts of food then PURGING through self-induced vomiting in an effort to prevent gaining weight

*abuse laxatives & diuretics

Question 5

Binge eating disorder

Answer 5

recurrent episodes of bingeing accompanied by emotional distress

Question 6

Avoidant restrictive food intake disorder

Answer 6

persistent failure to meet nutritional needs, inflexible eating behaviors, & fear based food restriction

Question 7

Othorexia
vs
Diabulimia

Answer 7

Othorexia = obsession w healthy eating leading to disturbance in adequate nutritional intake

Diabulimia = person w type 1 DM redues/stops taking insulin to drop weight

Question 8

Pica

Answer 8

consuming inedible objects
*children

Question 9

rumination disorder

Answer 9

intentional regurgitation of food in a repetitive manner, the rechewing, reswallowing, or spitting it out

Question 10

lanugo

Answer 10

*ANOREXIA
fine downy hair growth on skin

Question 11

Russel’s sign

Answer 11

callouses & bruising on the knuckles resulting from self-induced vomiting by sticking one’s finger down the throat

Question 12

Bulimia manifests as

Answer 12

at near or ideal body weight

parotid gland enlargement

Russels sign (calluses)

binge-purge cycle

dental erosion

skin problems
*hypokalemia
*GI problems
*dependency on laxatives

Question 13

refeeding syndrome

Answer 13

dangerous shift of fluid & electrolytes that occur within the body when reintroduced too quickly = heart failure

**anorexia

Question 14

“food is your medicine”

Answer 14

nursing intervention for eating disorders

Question 15

diet to promote cognitive function in alzheimer’s patients

Answer 15

MIND diet
*mediterranean diet

Question 16

gnosis vs praxis

Answer 16

gnosis = recognition of faces

praxis = imitating gestures or learned movements

Question 17

medications for delirium include

Answer 17

benzo’s, barbituates, & anti-psychotics

Question 18

Alzheimer’s Disease presents with

Answer 18

amyloid plaques & tau tangles
olfactory deficits
10 yr survival rate

Question 19

moderate Alzheimer’s presents with

Answer 19

-ASSISTANCE bathing & getting dressed

• sundowning (worse at night)
• confabulation (distorted memories)
• aphasia
  -apraxia (inability to perform even with physical ability in tact)
• agnosia (inability to recognize even w senses in tact )

Question 20

severe alzheimers presents with

Answer 20

*TOTAL CARE

• agraphia = inability to read or write
• hypermetamorphisis = feeling the need to touch everything in sight

-hyperorality = putting everything in the mouth

Question 21

Huntington’s Disease is evident on

Answer 21

chromosome 4

Question 22

music therapy for clients with Alzheimers..

Answer 22

evokes memories

Question 23

symptoms of delirium include

Answer 23

*HALLUCINATIONS
*VITAMIN DEFICIENCIES
confusion
irritability
hyperactivity
sweating tremors
tachycardia
impaired level of consciousness

Question 24

alzheimer’s disease is diagnosed using a

Answer 24

PET SCAN

Question 25

in clients with dementia, music therapy helps

Answer 25

improve appetite

Question 26

hospital admission criteria for eating disorders

Answer 26

less than 10% body fat 30% weight loss over 6mo inability to gain weight outpatient *danger to self

Question 27

Type 1 vs Type 2 Anorexia

Answer 27

Type 1 = restrict caloric intake Type 2 = purging, laxatives, induced exercise

Question 28

manifestations of anorexia

Answer 28

*hypokalemia - amenorrhea - cachectic (muscle wasting) - constipation - decreased vitals - dizziness / fainting - lanugo (hypothermia) - pallor - palpitations

Question 29

4 items of nursing process when ASSESSING anorexia

Answer 29

safety level of insight understanding of disease eat 75% of meals

Question 30

IMPLEMENTING nursing process for anorexia

Answer 30

*behavioral (privileges take away) - 30 min time frame to eat - weigh after void (same time & clothes) - observe patient while eating & 1 hour after

Question 31

medication for anorexia only

Answer 31

*Olanzipine --weight gain & obsessive thoughts

Question 32

medication for bulimia

Answer 32

*Fluoxetine -- SSRI bulimia + co-morbidity

Question 33

executive functioning involves

Answer 33

ability to manage daily tasks decisions & planning

Question 34

delirium is a

Answer 34

comorbidity that affects the elderly & younger population

Question 35

delirium manifests

Answer 35

suddenly w/ elevated unstable vitals *hallucinations *illusions *decreased visiospatial ability decreased functioning & focus labile (moody) restless anxious motor agitation sundowning (worse @ night)

Question 36

3 types of delirium

Answer 36

1. Hyperactive = mood swings 2. Hypoactive = drowsy & least recognized 3. Mixed = switching

Question 37

interventions for delirium

Answer 37

*well-lit room w low level stimuli - fall risk = socks - reality orientation - introduction w each interaction - 1:1 sitter - room close to nursing station

Question 38

primary vs secondary dementia

Answer 38

primary= irreversible secondary = delirium not treated causing dementia

Question 39

dementia defense mechanisms

Answer 39

avoidance of questions confabulation denial preservation (repeats to avoid ?)

Question 40

dementia manifests as (4 a's)

Answer 40

amnesia agnosia = loss of sensations aphasia = loss of words apraxia = loss of movement

Question 41

3 medications for mild to moderate alzheimers

Answer 41

** take @ END of day Donepezil hydrochloride Galantamine hydrobromide Rivastigmine tartrate *slows progression * GI side effects - n/v/d *bradycardia *syncope

Question 42

medication for moderate to severe AD

Answer 42

Memantine hydrochloride limited benefits causes: headache dizziness constipation

Question 43

dementia defense mechanisms

Answer 43

denial confabulation preservation avoidance of questions