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NUR 135 test 2

QuestionAnswer
Ways in which bulimia affects your whole body Anxiety, no self-esteem, depression, cavities, tooth enamel erosion, gum disease, irregular heartbeats, sore throat tears and ruptures in throat, muscle fatigue, stomach ulcers, abrasion of the knuckles and dry skin
Ways in which anorexia affects your whole body Fear of gaining weight, sad, fainting due to lack of glucose, dry brittle hair, low blood pressure, heart palpitations, anemia, muscle weakness, fractures, kidney failure, low potassium,& sodium, trouble getting pregnant, skin bruises easily, growth of fi
Reasons why people have eating disorders Disturbed body image, Control, Environmental pressure or peer pressure
Client refuses to maintain normal weight…..body weight is less than 15% expected for BMI Anorexia Nervosa *
Characteristics of anorexia nervosa Obsession with fitness, intense fear of gaining weight, they do not lose their appetite, they have a disturbed body image, use exercise dieting fasting laxative diuretics or enemas to control weight
Characteristics of anorexia nervosa continued Ritualistic food behaviors, depression, social withdrawal, insomnia, decreased interest in sex, inflexible thinking, strong need for control
Treatments for anorexia nervosa Treat medical conditions first and then psychological. They may need immediate hospitalization. Restore weight, correct in balances, rehydrate, provide nutritional support, monitor I’s & O’s, elimination, vital signs, & activity level. Be aware of manipul
How much weight do you want to see an anorexic personal gain a day 0.5lbs
Compensatory behaviors to avoid weight gain Purging or self induced vomiting use of laxatives, diuretics, enemas, or emetics. Fasting or excessive exercise may also be used.
Bulimia nervosa Recurrent episodes of binge eating followed by compensatory behaviors to avoid waking for at least two times a week for three months
Characteristics of bulimia nervosa Consumes large amounts of food in less than two hours, they are aware that their behavior is abnormal but fear stopping because they’re afraid they will gain weight. Self-critical and experience guilt after each episode. Can Experience depression, anxiety
What might a patient with bulimia nervosa get from purging or overuse of laxatives Metabolic acidosis
Bulimia nervosa treatment* *Outpatient treatment, cognitive strategies, food diary and records moods, relaxation and distraction to help manage emotions, explore self perceptions, help identifies personal strengths and interests, teach nutritional needs and affects of binging and p
Bulimia nervosa treatment continued They must eat in the presence of others give them positive feedback for their efforts refer them to over eaters anonymous, set realistic goals for eating such as gaining weight and not vomiting. Encourage family and friends to provide emotional support, l
What is ECT Electroconvulsive therapy
Who is a candidate for ECT Patients with sever long lasting depression, other treatments have been ineffective
What S&S will a client display following ECT Headache,confusion, short term amnesia, & improved mood
What is the client care undergoing ECT Baseline vitals, continued vital monitoring, short acting muscle relaxant, sedatives, and anesthesia
What are drugs used to treat mood disorders SSRI, MAOI, NRI, SMS, mood stabilizing, tricyclic
What is the first choice in antidepressants and why SSRI’s because they have less side effects
What is important to teach a patient about most antidepressants They usually take 2-4 weeks for results
What are the 3 levels of depression Mild, moderate, majority
How might a patient with major depression disorders present Feeling worthless, guilt and depression, poor concentration, decline in physical appearance, disrupted eating and sleeping habits
What is bipolar disorder Sudden dramatic shifts in mood between mania and depression
Bipolar 1 More severe with major depression & alternating episodes of mania. Psychotic symptoms may occur
Bipolar 2 Hypomanic moods that do not progress to full manic states. Less sever depression and mania but still devastating effects. Some can still engage in ADLS
What medication may be prescribed with bipolar and therapeutic range Lithium, 0.6-1.2
Toxic levels of lithium Greater than 1.5
What do toxic levels of lithium look like Sluggishness, severe diarrhea, slurred speech, blurred vision, diminished concentration, hand tremors
Seasonal affective disorder Mild moderate depression between October thru April
Priority intervention for suicidal clients Protect from harm…. And Do not leave alone
Risk factors for suicide Abuse, neglect, academic pressures, low socioeconomic status, mental health disorders, previous attempts, loss, male, unmarried, unemployed, medications, substance abuse, dysfunctional family
How do you assess for suicide Evaluate every client, assess risk factors, ask client directly
When is suicide most likely to occur When patient starts to feel better and regains energy
What should be obtained from suicidal patients No harm contract
Hallucinations Perceptions that have NO external stimuli. Involving taste, touch, smell, hearing, seeing
Delusion False beliefs that can’t be corrected by reasoning or explanation
Psych safety interventions Protect from harm… self first. Remove disruptive patient from others, no harm contract, remove objects of harm, set limits
Survivor guilt Guilt is main response of grief. Often feel like you could have done something to prevent it.
Levels of suicide Ideation, threat, gestures, parasuicidal behaviors, attempts, completion
Who is more successful at suicide Men…. Leading cause of death in 25-34 yr olds
Most older adults view suicide as God controlled, physician and individual controlled, individual controlled alone
Maslow hierarchy Physiological needs ( air, food, water, sleep, temp maintenance), need for safety and security ( feels safe and secure), love and belonging ( gives and receives love and feeling of belonging), esteem needs ( self respect, self esteem, respect and recogni
Maslow first level Must have before other needs are met…. Food, air, water, shelter, sleep, rest, activity, temp maintenance
Adults males over 65 Highest risk for suicide
Things containing tyramine Cheese, wine, beer, red meat
Potential side effects of antidepressants Hypertensive crisis, serotonin syndrome ( sleepy)
Antipsychotic side effects Extrapyramidal , tardive dyskinesia, neuroleptic malignant syndrome
The spectrum of human emotions range from Elation to despair
Depressed children Distinct way of thinking…. Bullying, poor self esteem
Cyclothmic disorder Repeated mood swings alternating between hypomania and depressive symptoms
Antimanics Lithium
Melancholy Sadness, despair, loss of functional status
Created by: Michelle McCourt
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