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HNN222 Exam > Week 7 - Eating disorders > Flashcards

Week 7 - Eating disorders Flashcards

1
Q

Define anorexia nervosa

A

an eating disorder characterised by a constant fear of gaining weight, distorted body image, and a body weight of 85% or more below normal

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2
Q

Distinguish between restricting anorexia and binging/purging anorexia

A

Restricting - reducing amount of food to lose weight

Binging/purging - cycle of binging large amounts of food then purging (vomiting or laxatives)

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3
Q

Signs and symptoms of anorexia

A
  • weight 85% below normal
  • restrictive behaviours OR binging/purging
  • excessive exercise
  • frequent weight checks
  • food rituals
  • refusal to a eat in public
  • low self esteem
  • perfectionist behaviour
  • desire for control
  • difficulty managing stress
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4
Q

Biological causes of anorexia

A
  • abnormalities in neurochemical signals which convey hunger/fullness
  • significant impact of genetic heritability
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5
Q

Psychological/environmental causes of anorexia

A
  • peer group pressure
  • popular culture
  • cultural values thinness
  • parenting style
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6
Q

Social media and anorexia

A
  • anorexia typically starts in teen years
  • rates higher when exposure to social media is increased
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7
Q

Lifestyle causes of anorexia

A
  • athletes who are focused on body weight/fat
  • dancing, modelling, wrestling
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8
Q

Characteristics of anorexia - fear of weight gain

A

People display a psychological obsession with caloric and fat content of food

this can lead to
* restrictive behaviours
* purging
* excessive exercise
* frequent weight checks

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9
Q

Characteristics of anorexia - food rituals

A

People consume food in a ritualistic way to maintain a sense of control
* eating in small pieces
* eating food in a specific order

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10
Q

Characteristics of anorexia - social/public eating

A
  • refusal to eat in front of people
  • may cook elaborate meals but not eat themselves
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11
Q

Impact of anorexia - Muscles

A

Anorexia causes significant muscle loss

this can lead to
* low creatinine levels
* fatigue
* diaphragm fatigue - resp distress

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12
Q

Impact of anorexia - Cardiac

A

Significant cardiac muscle loss

leads to
* bradycardia
* hypotension
* orthostatic hypotension
* congestive heart failure - oedema in feet

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13
Q

Impact of anorexia - electrolytes and vitamins

A

significant electrolyte and vitamin deficiencies (which can impact things like cardiac function)
* potassium
* magnesium
* phosphate
* vitamin B1

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14
Q

Impact of anorexia - Menstruation

A

Women may experience amehorrhea
* menstruation stops
* menstruation doesnt start by age 15

Infertility

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15
Q

Impact of anorexia - GIT

A

The stomach’s ability to tolerate a normal sized meal decreases leading to
* bloating
* N+V
* constipation

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16
Q

Impact of anorexia - Bones

A

Bone marrow starts shutting down

Fewer WBC –> dampened immune response
Fewer RBC –> low energy
Fewer platelets –> easy bruising and bleeding

Osteoperosis - bones weaken

17
Q

Impact of anorexia - Skin

A
  • Skin can become dry and scaly
  • lanugo (extreme biological attempt at thermoregulation when not enough muscle mass to metabolise)
  • hair becomes brittle and falls out easily
18
Q

Impact of anorexia - Brain

A

Atrophy

Encephalopathy (damage or disease to the brain which alters its structure or function)
* ataxia (loss of coordination)
* confusion
* death

19
Q

Halitosis

A

Bad breath due to repeated vomiting

20
Q

Refeeding syndrome

A

Refeeding stimulates the secretion of INSULIN
* causes the cells to take in POTASSIUM, MAGNESIUM, PHOSPHATE (already low in the blood)
* concentration of these ions becomes dangerously low
* can lead to cardiac arrhythmias and death

Requires careful continuous medical monitoring and ECG during the refeeding process

21
Q

Identify and explain non pharmacological treatment of anorexia

A

CBT specifically beneficial in BN

Medicalised approach to careful weight gain

Psychotherapy and CBT
* for the individual and family if required
* can aim to improve self esteem
* helps to cope with the stress and social pressures by teaching calming/coping strategies
* teaching to identify thought patterns which might be influencing their illness

22
Q

Pharmacological intervention in conjunction

A

Olanzapine in small doses (antipsychotic) - increases appetite and weight gain is common

Antidepressants - Common comorbid depression with EDs, and may be useful in addressing certain psychological causes of EDs and preventing relapse

23
Q

Identify nursing interventions and rationale for people with anorexia

A

supervise/provide support during mealtimes

build rapport

MSE and risk assessment

Collaborate with consumer to develop a plan based on their goals for recovery

Provide psychoeducation

Monitor for refeeding syndrome

Blind weights

Promote coping/soothing strategies

Promote healthy exercise for mental health

Promote postive body image

24
Q

Define bulimia nervosa

A

an eating disorder characterised by rapid out of control binge eating beyond levels of comfort, ofllowed by pueging through vomiting, laxatives or diuretics

Must occur once a week for three months to be diagnosed

25
Signs and symptoms of bulimia
* Low self esteem * normal or overweight * strong desire for control over weight * fixation on food * eating rapidly * russells signs * hiding/hoarding food * feelings of dysphoria * lack of control * eating alone * frequent dieting
26
Biological causes of bulimia
* evidence of significant genetic heritability * lower plasma levels of BDNF gene associated with BN development * serotonin imbalance
27
Social/environmental causes of bulimia
* poor self esteem * controlling personality * parenting style * bullying * abuse
28
Social media and bulimia
* high incidence of bulimia in adolescence * higher rates of bulimia where media exposure increases * enterainment and body goals * thinness is valued as a cultural norm
29
Lifestyle causes of bulimia
athletes who are focused on body weight/fat eg. dancing, modelling, wrestling
30
Other disorders and eating disorders
Those who experience EDs are also likely to experience * OCD * depression * anxiety These share many overlapping symptoms and risk factors
31
Impact of bulimia - vomiting
* erosion of teeth enamel * halitosis * swelling of parotid gland * russels sign Mallory Weiss syndrome * tears to distal oesophagus and stomach * causes abdominal pain and haemataemesis
32
Impact of bulimia - cardiac
vomiting -> dehydration -> hypotension and tachycardia
33
Impact of bulimia - Electrolytes
Low * sodium * potassium * magnesium * chloride * phosphate Low K -> muscle weakness and cardiac arrhythmias * may lead to death Metabolic alkalosis
34
Impact of bulimia - Endocrine
Amenorrhea High risk of Diabetes Mellitus * purging = food restriction -> places cells in state of starvation * DM makes glucose more difficult to enter cells due to insulin insensitivity -> worsens state of starvation
35
Identify and describe non pharmacological treatments for bulimia
Medical apporach to careful nutrition is important Psychoeducation * individual can understand their condition, what are the triggers and how to best manage them Psychotherapy and CBT * For the individual and family if necessary * To guide individual in structuring a new relationship with food * Eg. encouraging consuming a small amount of a ‘forbidden’ food → consciously noticing the absence of negative consequences
36
Pharmacological treatments for bulimia and anorexia
SSRIs in conjunction with therapy - have been shown to reduce the frequency of binging and purging Also can tackle the depressive psychological tendencies which might contribute to ED
37
Identify nursing interventions and rationale for people experiencing bulimia
Understand that person’s priorities Recovery based approach Work with individual on strategies to support their feeding process Encourage support/connections supervise/provide support during mealtimes build rapport MSE and risk assessment Collaborate with consumer to develop a plan based on their goals for recovery encourage a food diary Provide psychoeducation Blind weights Promote coping/soothing strategies Promote healthy exercise for mental health Promote postive body image
38
SCOFF questionnaire
**S** - do you ever make yourself sick because you feel uncomfortably full **C** - Do you worry you have lost cnotril over how much you eat **O** - Have you recently lost more than 6kg in a three month period **F** - do you believe yourself to be fat when others say you are too thin **F** - would you say that food dominates your life One or two postive answers should raise suspicion - full assessment for eating disorder and consultation with an eating disorder or mental health clinician is needed

HNN222 Exam (8 decks)

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