Week 6 Part 3: Eating Disorders Flashcards

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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
Q

Anorexia nervosa has seen to be more common in what genetic inheretance that has been noticed

A

More common among sisters and mothers of those with the disorder than it is among the general populations

26
Q

Psychological Models of Eating Disorders

A

eating disorders associated with:

low self esteem

self doubts about personal worth

problems with separation

problems with sexuality

27
Q

Psychosocial influences on eating disorders

A

unresolved dependency needs

fixation in the oral stage of psychosexual development

28
Q

Biological theory of ED

A

Uncertain whether ED or neurochemical disturbances came first

originates in the hypothalamic, hormonal, NT, or biochem disturbances

29
Q

According to biological theory of ED, OCD, anorexia, bulimia are associated with excessive levels of ____ which is released when?

A

vasopressin; which is released during stress of physical or emotional origin

30
Q

Psychodynamic Influences of ED

A

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
Q

Psychosocial Theory of ED

A

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
Q

What mental illness has cognitive and behavioral similarities with eating disorders

A

OCD - ritualistic behaviors, irrational thoguhts and beliefs, anxiety

33
Q

Family Theory of ED

A
  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
Q

S/S of Anorexia Nervosa

A

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
Q

Weight loss in anorexia nervosa is usually more tha ___% of expected weight

A

15%

36
Q

S/S of Bulimia

A

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
Q

Nursing Dx for Anorexia/Bulimia

A

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
Q

What is an emergency situation from anorexia/bulimia

A

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
Q

Goals for Treatment for Anorexia and Bulimia involve what

A

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
Q

Planning and Implementation of of nursing care for EDs involve…

A
  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
Q

What is central to the etiology of all eating disorders

A

Issues of control

42
Q

For an ED tx program to be successful…

A

the client must perceived that he or she is in CONTROL of the treatment

43
Q

Success is observed with the ED patient when …

A
  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
Q

Treatment Modality for ED: Individual Therapy

A

helpful when udnerlying psychological problems are contributing to maladaptive behaviors

45
Q

Treatment Modality for ED: Family Therapy

A
  • 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
Q

What cognitive distortions of ED need to be attended to in ED tx

A

overgeneralizations

all or nothing thinking

catastrophizing

personalization

emotional reasoning

47
Q

Positive client outcomes for treatment of anorexia/bulimia occur when…

A
  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
Q

What % body weight do we want to see after ED tx

A

80% or more

49
Q

Psychopharmacology of ED

A

no medication is specifically indicated for eating disorders

however, various medications ahve been prescribed for associated symptoms such as: Anxiety and Depression

50
Q

Topamax

A

Drug with SOME success for treating binge eating disorders

51
Q

Medications given to ED patients tend to focus on…

A

depression and anxiety rather than the ED themselves as the emds only ive some success regardin the ladder

52
Q

It is important to educate the client and family of an ED about what 2 topics

A

Nature of the illness

Management of the illness

53
Q

What things about nature of the illness should be taught for ED

A

symptoms of anorexia and bulimia nervosa

causes of ED

effects of illness or condition on the body

54
Q

What things about management of the illness should be taught for ED

A

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
Q

Support Services for ED

A

national association of anorexia nervosa and associated disorders

the american anorexia/bulimia association, inc

56
Q

What is important about the evaluation of ED post-tx

A

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
Q

When trying to heal an ED what will be needed by both client AND family members

A

behavioral changes