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NURS363 - Practice of Nursing IV > Week 6 Part 3: Eating Disorders > Flashcards

Week 6 Part 3: Eating Disorders Flashcards

1
Q

Eating Disorder

A

Consistently less than or more tha body’s caloric need to maintain a healthy body weight

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2
Q

Eating disorders are accompanied by…

A

anxiety and guilt

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3
Q

Eating Disorders occur without…

A

hunger or failure to product satiety

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4
Q

Eating disorders result in …

A

physiologic imbalances and medical complications

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5
Q

3 Important eating Disorders

A

Anorexia Nervosa

Bulimia Nervosa

Binge Eating Disorder

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6
Q

Binge Eating Disorder

A

recurrent consumption of large amounts of food - compulsive overeating

no inappropriate compensatory behaviors like purging in bulemia

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7
Q

Anorexia Nervosa

A

Life threatening condition of distrubed body image, leads to emaciation with the intense fear of becoming obese

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8
Q

How high is the anorexia nervosa mortality rate

A

Very high mortality rate - 7-10% - with high rates of suicide

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9
Q

Bulimia Nervosa

A

recurrent pattern of uncontrollable consumption of large amounts of food (binge eating) followed by attempts to eliminate the body of excess calories (purging)

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10
Q

Anorexia causes a very irrational fear of…

A

obesity

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11
Q

Binge Eating Disorder easting is associated with what characteristics

A

fast consumption

eating alone

guilt

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12
Q

20-30% of obese individuals report…

A

having done binge eating

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13
Q

what % of the US population may have anorexia or bulemia

A

1-4%

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14
Q

Why is it so difficult to assess amounts of eating disorders

A

most binge and purge in secret and their weight remains WNL (especially bulemia)

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15
Q

What groups and demogrpahics tend to get eating disorders

A

historically, whites that are well educated adolescents to young adults

Wide distribution among classes and cultures

Can manifest and persist into middle and later adulthood

Incidence of males increasing but higher rate in females

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16
Q

What is the ratio of male to female with anorexia

A

1M:2F

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17
Q

What is the ratio of male to female with bulemia

A

1M:3F

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18
Q

What subgroup of males has a higher incidence of eating disorders

A

homosexual males

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19
Q

What populat emphasis contributes to eating disorders

A

fitness

lean muscle mass

stringent weight requirements

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20
Q

What group is less likely to seek help for eating disorders, and come to clinic further progressed

A

males

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21
Q

Etiology of Eating Disorders

A

varies and is influenced by impaired psychosocial fxns, medical conditions, and psychiatric co-morbidities

Multi-factorial: develops based on interactions with family, individuals, and sociocultural influences

Vuln. pop, uncontrolled dieting,genetics, puberty, major life changes, stressors, family fxning or dysfunction, emphasis in thinness, all can contribute

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22
Q

Main Theory of Eating Disorders

A

Transactional model of Stress/Adaptation

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23
Q

Transactional Model of Stress/Adaptation

A

Etiology theory on eating disorders where most likely they are influenced by mult. factors including:

genetic models
psych models
psychosocial influences
biological theories
psychodynamic influences
family theory
24
Q

Genetic Model of Eating Disorders

A

A hereditary predisposition to eating disorders hypothizied from genetics

25
Anorexia nervosa has seen to be more common in what genetic inheretance that has been noticed
More common among sisters and mothers of those with the disorder than it is among the general populations
26
Psychological Models of Eating Disorders
eating disorders associated with: low self esteem self doubts about personal worth problems with separation problems with sexuality
27
Psychosocial influences on eating disorders
unresolved dependency needs fixation in the oral stage of psychosexual development
28
Biological theory of ED
Uncertain whether ED or neurochemical disturbances came first originates in the hypothalamic, hormonal, NT, or biochem disturbances
29
According to biological theory of ED, OCD, anorexia, bulimia are associated with excessive levels of ____ which is released when?
vasopressin; which is released during stress of physical or emotional origin
30
Psychodynamic Influences of ED
suggests that eating disorders result from very early and profound disturbances in mother-infant interactions, resulting in: 1. Retarded ego development 2. Unfulfilled sense of separation-individuation
31
Psychosocial Theory of ED
may diet to lose weight to gain enhances in physical appearance and received attn form others - can be positive or negative Mood disorders, anxiety disorders, low self esteem, perfectionism, perseverance (Determination), avoidance, all appear to be predisposing eating disorder factors
32
What mental illness has cognitive and behavioral similarities with eating disorders
OCD - ritualistic behaviors, irrational thoguhts and beliefs, anxiety
33
Family Theory of ED
1. Family influences and conflict avoidance - promote and maintain psychosomatic symptoms and the sick child becomes the problem and focus on the conflict is diverted 2. Elements of power and control - parental criticism, love, aproval, recognition all influence
34
S/S of Anorexia Nervosa
Extreme Weight Loss Amenorrhea, Hypothermia, Bradycardia, Hypotension, edema, Lanugo, and metabolic changes Family involvement Amenorrhea is typical and may preceded significant weight loss Obsession with food - always talking about it Feelings of anxiety and depression common
35
Weight loss in anorexia nervosa is usually more tha ___% of expected weight
15%
36
S/S of Bulimia
episodic, uncontrolled, compulsive, rapid ingestion of large quantities of food over short periods (Binging) Episode followed by inappropriate compensatory behaviors to rid the body of excess calories (self induced, vomiting or the misuse of laxatives, diuretics, or enemas)
37
Nursing Dx for Anorexia/Bulimia
Imbalanced Nutrition: LESS than body requirements r/t refusal to eat Deficient fluid volume: Risk for or actual r/t decreased fluid intake, self induced vomiting, and laxative and/or diuretic abuse Disturbed body image / low self esteem / retarded ego development, dysfunctional family system, or feelings of dissatisfaction w/ body appearance Ineffective Denial r/t retarded ego development and fear of losing the only aspect of life over which he or she perceives some control (eating) Imbalanced nutrition - more than body requirements r/t compulsive overeating Disturbed body image/ low self esteem/ retarded ego development, dysfunctional family system or feelings of dissatisfaction w/ body appearance Anxiety (moderate to severe) r/t feelings of helplessness and lack of control over life events
38
What is an emergency situation from anorexia/bulimia
excessive vomiting and laxative or diuretic abuse may lead to problems with ehydration and electrolyte imbalances Multiple physiological disorders related to the consequences of starvation Kidney and liver disorders
39
Goals for Treatment for Anorexia and Bulimia involve what
Client will: Verbalize knowledge regarding consequences of fluid loss caused by self induced vomiting (or laxative/diuretic abuse) and importance of adequate fluid intake Verbalizes events that precipitate anxiety and demostrates techniques for its reduction Verbalizes ways in which (s)he may gain more control of the environment and thereby reduce feelings of helplessness Expresses interest in welfare of other and less preoccupation with own appearance Verbalizes that image od body as "fat" was misperception Demostrates ability to take control of own life without resorting resorting to maladaptive Eating behaviors (anorexia nervosa)
40
Planning and Implementation of of nursing care for EDs involve...
1. Restoring nutritional balance 2. emphasis of helping the client GAIN CONTROl over life situation 3. self esteem and positive self image are promoted in ways that relate to aspects other than appearance
41
What is central to the etiology of all eating disorders
Issues of control
42
For an ED tx program to be successful...
the client must perceived that he or she is in CONTROL of the treatment
43
Success is observed with the ED patient when ...
1. The client is allowed to contract privileges based on weight gain, has input into care plan, clearly sees what treatment choices are 2. Client has control over eating, amount of exercise, whether to induce vomiting 3. Staff and client agree about goals and system of rewards
44
Treatment Modality for ED: Individual Therapy
helpful when udnerlying psychological problems are contributing to maladaptive behaviors
45
Treatment Modality for ED: Family Therapy
- Really important to care Involves eduating the family on the disorders Assesses the familys impact on maintaining the disorder Assists in methods to promote adaptive functioning by the client
46
What cognitive distortions of ED need to be attended to in ED tx
overgeneralizations all or nothing thinking catastrophizing personalization emotional reasoning
47
Positive client outcomes for treatment of anorexia/bulimia occur when...
1. The client has achieved and maintain at least 80% of expected body weight 2. Has VS stability, BP and lab serum students wnL 3. Verbalizes importance of adequate nutrition 4. Adequacy or usual pattern of nutritional intake 5. Body weight, muscle and fat are congruent with gender and age 6. Positive body image * PATIENT SHOULD HAVE INSIGHT INTO ADEQUATE NUTRITION OR REALIZATIONS ON THINGS*
48
What % body weight do we want to see after ED tx
80% or more
49
Psychopharmacology of ED
no medication is specifically indicated for eating disorders however, various medications ahve been prescribed for associated symptoms such as: Anxiety and Depression
50
Topamax
Drug with SOME success for treating binge eating disorders
51
Medications given to ED patients tend to focus on...
depression and anxiety rather than the ED themselves as the emds only ive some success regardin the ladder
52
It is important to educate the client and family of an ED about what 2 topics
Nature of the illness Management of the illness
53
What things about nature of the illness should be taught for ED
symptoms of anorexia and bulimia nervosa causes of ED effects of illness or condition on the body
54
What things about management of the illness should be taught for ED
principles of nutrition ways client may feel incontrol of life importance of expressing fears and feelings, rather than holding them inside alternative coping strategies
55
Support Services for ED
national association of anorexia nervosa and associated disorders the american anorexia/bulimia association, inc
56
What is important about the evaluation of ED post-tx
evaluation of the client with an ED requires reassessment of the behaviors for which the client sought treatment - it is a lifelong battle for them
57
When trying to heal an ED what will be needed by both client AND family members
behavioral changes

NURS363 - Practice of Nursing IV (17 decks)

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