Chapter 22- Eating Disorder Final, Personality Disorders - Davis Edge, 360 Nursing test 3, Chapter 31. Eating Disorders, #30 - Eating Disorders

If they are more than 20% below ideal body weight

What is the cutoff for when you must hospitalize an anorexic pt?

Anxiety (50%)

What is the most common comorbidity of Anorexia?

(50% have comorbidities mood disorder) 50%+ comorbidities anxiety disorder

What is the most likely comorbidity of Binge Eating disorder?

True

(T/F) Heterosexual people have lower rates of Anorexia than Bi- or Homosexual individuals.

Question 4. Which personality disorder does the nurse suspect in the client with a psychiatric illness who has made recurrent suicide attempts? 1. Borderline personality disorder 2. Antisocial personality disorder 3. Histrionic personality disorder 4. Avoidant personality disorder

1. Borderline personality disorder Option 1: Suicidal attempts are common in a client with borderline personality disorder due to feelings of abandonment. At the same time, the client incorporates a measure of safety during these attempts. Option 2: Antisocial personality disorder is not characterized by suicidal attempts. The client with antisocial personality disorder will be aloof. This client will also fail to plan activities successfully. Option 3: A client with histrionic personality disorder shows excessive emotionality and attention-seeking behavior. However, this client does not show suicidal attempts. Option 4: A client with avoidant personality disorder does not show suicidal attempts. Instead, this client shows social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.

Question 17. Which symptoms does the nurse observe in the client with borderline personality disorder who is diagnosed with complicated grieving? 1. Depression 2. Suicide attempts 3. Manipulation of others 4. Alternating clinging and distancing behaviors

1. Depression Option 1: The client undergoes depression due to severe sorrow and grieving. Option 2: The client who attempts suicide is diagnosed with risk for suicide or risk for self-directed violence. Option 3: The client with chronic low self-esteem may manipulate others for personal gain. Option 4: Alternating clinging and distancing behaviors are observed in the client who is diagnosed with social impairment but not in the client who is undergoing complicated grieving.

Question 5. Which is the hypothesized reason that a client with borderline personality disorder does not sense pain after an attempt to cut his or her own wrist? 1. Elevated levels of endorphins 2. Elevated levels of acetylcholine 3. Elevated levels of serotonin 4. Elevated levels of noradrenaline

1. Elevated levels of endorphins Option 1: Elevated levels of endorphins result in an increase in the threshold for pain. Therefore, pain is not strongly felt when the client cuts his or her wrist. Option 2: Acetylcholine is a neurotransmitter that helps in neurotransmission in the autonomic nervous system. Therefore, increased or decreased levels of acetylcholine have no effect on the sensation of pain. Option 3: Serotonin is useful in the regulation of intestinal movements, mood, appetite, and sleep. It is not mediated in the regulation of pain. Option 4: Noradrenaline is a neurotransmitter and hormone and is not related to pain regulation.

Question 7. The nurse is caring for a client with borderline personality disorder who has a history of physical abuse during childhood. The client's caregiver reports that the client is always depressed. Which nursing intervention may lead to regression in the client? 1. Exploring the source of anger with the client 2. Acting as a role model 3. Encouraging the client to take brisk walks 4. Explaining the behaviors associated with depression to the client

1. Exploring the source of anger with the client Option 1: Exploring the true source of anger with the client is a painful therapy that may lead to regression as the client deals with his or her feelings about the abuse. Option 2: Acting as a role model does not lead to regression. It helps the client express anger in an appropriate manner. Option 3: Encouraging the client to perform physical activities such as brisk walks helps discharge pent-up tension. Option 4: Explaining the behaviors associated with the grieving process such as depression relieves guilt in the client.

Question 24. The registered nurse is evaluating a student nurse who is caring for a client with borderline personality disorder. Which action of the student nurse does the registered nurse correct during the evaluation? 1. Leaving the client alone to work out stressful feelings 2. Observing the client's behavior frequently 3. Encouraging the client to talk about his or her feelings 4. Removing dangerous objects from the client's environment

1. Leaving the client alone to work out stressful feelings Option 1: The client with borderline personality disorder would not be left alone during stressful times because it may cause an acute rise in anxiety and agitation levels. Option 2: The nurse would observe the client's behavior frequently so that if any self-mutilating behaviors are performed, the nurse can provide immediate intervention for the client's safety. Option 3: The nurse would encourage the client to talk about his or her feelings because it helps the nurse identify precipitating factors to plan appropriate treatment. Option 4: The nurse would remove dangerous objects from the client's environment so that the client will not use them to cause harm to self or others.

Question 12. The nurse is conducting a session with a group of clients diagnosed with personality disorders. Which nursing interventions provide the clients with alternative ways to deal with frustration? Select all that apply. 1. Social skills training 2. Group skills training 3. Assertiveness training 4. Individual psychotherapy 5. Psychoanalytical psychotherapy

1. Social skills training 3. Assertiveness training Option 1: Social skills training provides the client alternative ways to deal with frustration. Option 2: Group skills training teaches the client core mindfulness skills, emotion modulation skills, distress tolerance skills, and interpersonal effectiveness skills. Option 3: Assertiveness training provides the client with alternative ways to deal with frustration. Option 4: During individual psychotherapy, dysfunctional behavioral patterns, personal motivation, and skills strengthening are addressed. Option 5: Psychoanalytical psychotherapy focuses on the unconscious motivations for seeking total satisfaction from others and for being unable to commit oneself to a stable, meaningful relationship.

Question 9. After assessing the behaviors of a client with psychiatric illness, the nurse suspects the client has borderline personality disorder with impaired social interaction. Which findings would support the nurse's suspicion? Select all that apply. 1. The client splits on staff members. 2. The client manipulates staff members. 3. The client displays disorganized thinking. 4. The client misinterprets the environment. 5. The client alternates between clinging and distancing behaviors.

1. The client splits on staff members. 5. The client alternates between clinging and distancing behaviors. Option 1: The client will try to play one staff member against another. The client has impressions of others as good or bad. The client creating interpersonal conflicts indicates impaired social interaction. Option 2: The client will try to manipulate other staff members due to the fear of abandonment. As the client is creating interpersonal conflicts, it indicates impaired social interaction. Option 3: Transient psychotic symptoms such as disorganized thinking indicate panic or severe anxiety but not impaired social interaction. Option 4: Misinterpretation of the environment indicates derealization and not impaired social interaction. Option 5: The client with borderline personality disorder exhibits patterns of interaction with others characterized by alternating clinging and distancing behaviors.

Question 21. The nurse is caring for an 8-year-old child with a psychiatric illness. According to Erikson, which behavior indicates maladaptive development in the child? 1. Unable to gain self-confidence 2. Unable to keep up the promises made to peers 3. Unable to integrate the tasks mastered in the previous developmental stages 4. Unable to maintain lasting relationships

1. Unable to gain self-confidence Option 1: According to Erikson, a child between 6 and 12 years of age achieves a sense of self-confidence by learning, competing, and performing successfully. Therefore, a failure to develop self-confidence indicates developmental delay. Option 2: According to Erikson, an individual of 20 to 30 years will have the ability to keep a commitment made to others. Therefore, the inability of an 8-year-old child to keep promises made to peers does not indicate developmental delay. Option 3: According to Erikson, the child between 12 and 20 years of age has the ability to integrate the tasks mastered in the previous stages into a secure sense of self. Option 4: According to Erikson, an individual between 20 and 30 years of age has the ability form an intense and lasting relationship or keep a commitment to another person.

Assessment for a patient with a maladaptive response to eating regulation shows: height: 5'3"; weight: 80 pounds; weight loss of 30% over the past 3 months; T: 96.6; BP: 68/40; P:40; R:20; poor skin turgor; lanugo; amenorrhea for 6 months; restricts intake to 350 calories daily; dissatisfied with eating pattern AEB statement, "I need to lose another 10 pounds to be at an ideal weight." These assessment findings are most consistent with the medical diagnosis of: 1. Bulimia nervosa 2. Anorexia nervosa 3. Binge-eating disorder 4. Disturbed body image

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Question 10. Which personality disorder may be caused by predisposing factors such as an absence of parental discipline and having impulsive, inconstant parents? 1. Histrionic 2. Antisocial 3. Borderline 4. Narcissistic

2. Antisocial Option 1: An extreme variation of temperamental disposition is a predisposing factor for histrionic personality disorder. Option 2: Antisocial personality disorder is more likely to develop in children who have chaotic home environments. Having impulsive parents who do not provide discipline or consistency is a sign of a chaotic home environment, which is a predisposing factor for antisocial personality disorder. Option 3: Predisposing factors for borderline personality disorder are a decrease in serotonin levels and having family members with mood disorders. Option 4: Parental overindulgence is a predisposing factor for narcissistic personality disorder.

Question 16. While communicating with a 20-year-old client, the nurse finds that the client has deceitful, guiltless, and belligerent behavior. On reviewing the client's medical history, the nurse finds behaviors of the client include bullying or intimidating others, initiating physical fights, and cruelty to animals in childhood. Which disorder does the nurse suspect in this client? 1. Avoidant personality disorder 2. Antisocial personality disorder 3. Borderline personality disorder 4. Dependent personality disorder

2. Antisocial personality disorder Option 1: There are no reports of risk for avoidant personality disorder in the client who has conduct disorder in childhood. However, the client with avoidant personality disorder does not show guiltless behavior. Option 2: The client would be at least 18 years of age to predict antisocial behavior. Deceitfulness and guiltless and belligerent behaviors are common in the client with antisocial behavior. The predisposing factor for antisocial personality disorder is conduct disorder. Option 3: The client is at high risk for borderline disorder when the client's parent has antisocial personality disorder and is involved in substance abuse. Option 4: The client with dependent personality disorder may not show belligerent behavior. In addition, no reports exist for the risk of dependent personality disorder when the client has conduct disorder in childhood.

Question 18. Which intervention of the nurse needs correction while caring for a client with borderline personality disorder who has a nursing diagnosis of complicated grieving? 1. Exploring the true source of anger with the client 2. Decreasing attention when the client is acting out 3. Avoiding the counter-transfer of the negative feelings onto the client 4. Encouraging the client to participate in large motor activities

2. Decreasing attention when the client is acting out Option 1: Exploring the true source of anger is the effective nursing intervention because it helps the client reconcile the feelings associated with the grieving process, thereby delaying it. Option 2: The nurse would set limits on acting-out behaviors of the client and would be attentive while caring for the client. Decreasing attention toward the client may elicit dangerous consequences because the client might become violent toward self or others. Option 3: The angry behavior of the client may develop negative effects on the nurse, but the nurse would not transfer the negative feelings onto the client, and it would not interfere with the therapeutic process. Option 4: Encouraging the client to participate in large motor activities is an effective nursing intervention to relieve pent-up tension in the client.

While caring for a client with borderline personality disorder, the nurse finds that the client consumes large amounts of food and self-induces vomiting. The client also reports having an increased libido. Which does the nurse interpret from these findings? 1. The client is exhibiting clinging behavior. 2. The client is experiencing impulsive behavior. 3. The client is exhibiting splitting behavior. 4. The client is exhibiting distancing behavior.

2. The client is experiencing impulsive behavior. Option 1: The client with borderline personality disorder has unstable relationships. He or she alternates between clinging and distancing behaviors. Option 2: The impulsive behaviors associated with borderline personality disorder include promiscuity, binging, and purging, such as in the client who consumes large amounts of food and self-induces vomiting. The client's urges to have sex with different partners frequently indicates promiscuity. Option 3: Splitting behavior is evident when the client lacks the ability to achieve an object of constancy. Option 4: If the client appears angry or hostile and feels discomfort with closeness, this indicates that the client is experiencing a distancing behavior.

Question 22. Which response of the client diagnosed with antisocial personality disorder with impaired social interaction and defensive coping indicates that psychotherapy is effective? 1. The client ridicules a manic client in the psychiatric unit. 2. The client plays a leading role in a group activity without expressing grandiosity. 3. The client requests the nurse to excuse him or her from a particular task. 4. The client declares that his family is responsible for his condition.

2. The client plays a leading role in a group activity without expressing grandiosity. Option 1: Psychotherapy aims to help the client interact with others and develop sensitivity toward others. Ridiculing another client shows that the client with antisocial personality disorder is not sensitive and does not show empathy for others. Option 2: A client with antisocial personality disorder shows impaired social interaction and defensive coping. A client who plays a leading role in a group activity indicates improvement of the symptoms, which may be the result of effective treatment. This is because the client cooperates with others and interacts well. Option 3: A request to be excused from a particular task does not indicate progress or effective treatment. Option 4: Psychotherapy aims to help clients take responsibility for their own actions in order to improve their conditions. A client declaring the family to be responsible does not indicate effective treatment.

Question 8. The nurse is caring for a client who self-mutilates. On assessment, the primary health-care provider concludes that the client has borderline personality disorder and instructs the nurse to encourage the client to verbalize fears after providing treatment. Which positive outcome does the nurse expect to see in the client? 1. The client needs personal progression through this process. 2. The client seeks out staff when the desire for self-mutilation occurs. 3. The client gains sufficient self-control to limit maladaptive behaviors. 4. The client completes activities of daily living independently.

2. The client seeks out staff when the desire for self-mutilation occurs. Option 1: The client needs personal progression through the process when the client diagnosed with complicated grieving explores his or her true source of anger. Option 2: The client with borderline personality disorder performs self-destructive behaviors due to poor impulse control. The primary health-care provider instructs the nurse to encourage verbalization of fears in a nonthreatening manner so that the client orients to the reality and seeks out staff when the desire for self-mutilation occurs. Option 3: The client gains sufficient self-control to limit maladaptive behaviors if the nurse explains that these behaviors are unacceptable in a nonthreatening manner. Option 4: The client completes activities of daily living independently when client independence is encouraged and positive reinforcement is provided.

Question 14. Which statement of the registered nurse describes the predisposing factor for antisocial personality disorder? 1. "Children who receive parental pampering are at high risk for antisocial personality disorder." 2. "Children who are more attached to their single parent are at high risk for antisocial personality disorder." 3. "Children who are exposed to sexual and physical abuse are at high risk for antisocial personality disorder." 4. "Children who are belittled and abandoned are at high risk for antisocial personality disorder."

3. "Children who are exposed to sexual and physical abuse are at high risk for antisocial personality disorder." Option 1: Parental pampering is the predisposing factor for narcissistic personality disorder. Option 2: Children who are more attached to their single parent are at high risk for dependent personality disorder. Option 3: Childhood trauma, such as sexual and physical abuse, is the predisposing factor for antisocial personality disorder. Option 4: Children who are belittled and abandoned are at high risk for avoidant personality disorder.

Question 11. Which developmental task would a 9-year-old client accomplish, according to Erikson's theory of personality development? 1. Integrate the tasks mastered 2. Achieve the established life goals 3. Develop a sense of self-confidence 4. Ability to direct own activities

3. Develop a sense of self-confidence Option 1: Individuals between 12 and 20 years of age integrate the tasks mastered in the previous stages. Option 2: Individuals between 30 and 65 years of age try to accomplish established life goals. Option 3: Children between 6 and 12 years of age learn the skills to achieve a sense of self-confidence. Option 4: According to Erikson's theory of personality development, a 5-year-old client would begin to develop the ability to direct his or her own activities.

Question 23. Which intervention by the nurse may assist a client with antisocial personality disorder in learning to delay gratification? 1. Convincing the client to develop acceptable behaviors 2. Providing positive feedback for acceptable behaviors 3. Increasing the length of time required for acceptable behaviors by promising a reward to the client 4. Explaining the consequences of violation of limits on maladaptive behaviors

3. Increasing the length of time required for acceptable behaviors by promising a reward to the client Option 1: The nurse would not convince or coax the client in order to achieve acceptable behaviors. Convincing does not delay the gratification of the client's own desires. Option 2: Providing positive feedback enhances self-esteem in the client. However, this intervention does not help the client learn how to delay gratification. Option 3: The client learns to delay gratification of his or her own desires and is able to cope adaptively when the nurse begins to increase the length of time required for acceptable behavior in order to achieve a reward. Option 4: The client decreases the repetition of maladaptive behaviors when the nurse explains the undesirable consequences of maladaptive behaviors, but this does not help the client learn how to delay gratification.

Question 20. Which behaviors are present in a client with borderline personality disorder? Select all that apply. 1. Suspicious behavior 2. Exploitative behavior 3. Manipulative behavior 4. Splitting behavior 5. Self-destructive behavior

3. Manipulative behavior 4. Splitting behavior 5. Self-destructive behavior Option 1: A client with borderline personality disorder is not suspicious. However, clients with avoidant and paranoid personality disorders are suspicious about others. Option 2: A client with borderline personality disorder is not exploitative. However, clients with antisocial and narcissistic personality disorders are exploitative. Option 3: A client with borderline personality disorder is a master of manipulation. The nurse would be aware of this behavior of the client to prevent staff splitting. Option 4: A client with borderline personality disorder causes staff splitting due to the fear of abandonment. Option 5: Repetitive self-mutilating behaviors are classic manifestations of a client with borderline personality disorder.

Question 19. While caring for a client with borderline personality disorder who is diagnosed with impaired social interaction, the nurse avoids giving attention to the client when he or she tries to degrade other staff members. Which outcome does the nurse expect out of this intervention? 1. The client develops fear of abandonment. 2. The client develops a feeling of insecurity. 3. The client decreases the use of manipulative behaviors. 4. The client increases clinging and distancing behaviors.

3. The client decreases the use of manipulative behaviors. Option 1: The client may not develop fear of abandonment because the client may interact with other staff members when one staff member does not listen to him or her. Option 2: The client may not develop a feeling of insecurity because not listening to the client is the last intervention performed by the nurse. The nurse has already developed a feeling of security in the client through his or her accepting attitude. Option 3: The client recognizes that use of manipulative behaviors is inappropriate and decreases the use of staff splitting or manipulative behaviors when the nurse does not give the client attention. Option 4: The nurse would minimize the attention toward the client when he or she is exhibiting clinging and distancing behaviors. This helps prevent such behaviors in the client.

Question 6. While caring for a client with antisocial personality disorder, the nurse says to the client, "You may go bowling this weekend if you behave properly with your roommates." Which is the reason behind this nursing intervention? 1. To reduce aggressiveness in the client 2. To make the client feel guilty 3. To help the client delay gratification 4. To be overfriendly with the client

3. To help the client delay gratification Option 1: The client becomes calm when left alone. In this way, the nurse can reduce aggressiveness in the client. Option 2: The nurse is not trying to make the client feel guilty, but is trying to explain that certain behaviors are unacceptable. Option 3: The client with antisocial personality exploits others for self-gratification. The nurse is trying to help the client delay gratification by increasing the length-of-time requirement for acceptable behavior. Option 4: The nurse is not trying to be overfriendly with the client through this intervention. The nurse avoids overfriendly behavior as the client may become manipulative and misinterpret the nurse's behavior.

Susan is 5′8″ tall and weighs 105 pounds. She has been taking laxatives daily, and self-induces vomiting after eating. Which is the priority nursing diagnosis for this client? 1. Ineffective denial 2. Disturbed body image 3. Low self-esteem 4. Imbalanced nutrition, less than body requirements

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When interviewing a female adolescent with anorexia nervosa who is malnourished and severely underweight, the nurse identifies that the client is experiencing secondary gains from her behavior when she says: 1. "I am as fat as a house." 2. "I get straight A's in school." 3. "My hair is beginning to fall out." 4. "My mother keeps trying to get me to eat."

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Question 13. Which symptom indicates that the client has antisocial personality disorder with defensive coping? 1. Cruelty to animals 2. Overt aggressiveness 3. Dysfunctional interaction with others 4. Projection of blame and responsibility

4. Projection of blame and responsibility Option 1: Cruelty to animals indicates that the client has antisocial personality disorder with risk for other-directed violence. Option 2: Overt aggressiveness toward others indicates that the client has antisocial personality disorder with chronic low self-esteem. Option 3: Dysfunctional interaction with others indicates that the client has antisocial personality disorder with impaired social interaction. Option 4: Projection of blame and responsibility on others indicates that the client has antisocial personality disorder with defensive coping.

Question 3. Which statement by the nurse will most likely be effective while caring for a client with antisocial personality disorder who is diagnosed with defensive coping? 1. "You should eat at 11 a.m. daily." 2. "You should not wander in the corridor." 3. "Don't go outside without my permission." 4. "You are expected to be friendly with the nursing staff."

4. "You are expected to be friendly with the nursing staff." Option 1: The nurse would not order the client because the client may misinterpret the nurse's words due to weak ego development. Option 2: The client with antisocial personality disorder will frequently be irritated and aggressive. The client becomes more irritable and aggressive when the nurse shows a commanding attitude. So, it is recommended to always use "please" while conversing with the client. Option 3: The nurse would not give commands to the client. The nurse would use the word "please" to develop trust, which further establishes the therapeutic relationship. Option 4: The usage of words such as "you will be expected to ..." will develop a positive impression of the nurse. Thus, the client may cooperate with the nurse during the treatment.

Question 2. Which nursing intervention would be included in the care plan of a client with antisocial personality disorder who is diagnosed with defensive coping? 1. Use mechanical restraints 2. Administer tranquilizing agents 3. Maintain a stimulating environment 4. Discuss behaviors that are acceptable according to societal norms.

4. Discuss behaviors that are acceptable according to societal norms. Option 1: Mechanical restraints are useful only to the clients who are at high risk for violence directed at others. A client with defensive coping does not exhibit violent behavior. Instead, this client shows maladaptive behavior that may not require mechanical restraints. Option 2: Tranquilizing agents are administered to calm down the client and to allay hostile behaviors in the client. These agents are not necessary for the client who is not coping well. Option 3: A stimulating environment increases agitation and promotes aggressive behavior. However, a nonstimulating environment is not necessary for a client who shows defensive coping. Option 4: A client with defensive coping shows defensive, rationalizing behavior while interacting with others. Therefore, the nurse would discuss the behaviors that are acceptable according to societal norms to promote self-awareness in the client.

Question 15. Which client is at high risk for antisocial personality disorder? 1. The client whose parent has conduct disorder in childhood 2. The client whose parent is involved in substance abuse 3. The client who has post-traumatic stress disorder in adolescence 4. The client who has attention deficit-hyperactivity disorder in childhood

4. The client who has attention deficit-hyperactivity disorder in childhood Option 1: The client who shows conduct disorder in childhood and adolescence is at high risk for antisocial personality disorder. No reports are established regarding the risk of antisocial personality disorder in the child whose parent has conduct disorder. Option 2: The client whose parent is involved in substance abuse is at high risk for borderline personality disorder. Option 3: Post-traumatic stress disorder in adolescence does not cause antisocial personality disorder. Option 4: The predisposing factor for antisocial personality disorder is attention deficit-hyperactivity disorder in childhood and adolescence.

The Maudsley approach to treatment of adolescents with anorexia nervosa advances which of the following fundamental concepts? A. Family should be actively involved in each phase of treatment. B. Parents should be prohibited from involvement in helping their child eat more because there are often control issues. C. Adolescents needs to work on developing healthy self-identities before they can begin gain weight. D. Individual psychotherapy is the most effective treatment for adolescents with anorexia nervosa.

A

borderline personality disorder

A disorder characterized by a pattern of intense and chaotic relationships with affective instability; fluctuating and extreme attitudes regarding other people; impulsivity; direct and indirect self-destructive behavior; and lack of a clear or certain sense of identity, life plan, or values.

narcissistic personality disorder

A disorder characterized by an exaggerated sense of self-worth. These individuals lack empathy and are hypersensitive to the evaluation of others.

schizotypal personality disorder

A disorder characterized by odd and eccentric behavior, not decompensating to the level of schizophrenia.

antisocial personality disorder

A pattern of socially irresponsible, exploitative, and guiltless behavior, evident in the tendency to fail to conform to the law, develop stable relationships, or sustain consistent employment; exploitation and manipulation of others for personal gain is common.

dependent personality disorder

A personality disorder characterized by pervasive, excessive dependency needs, submissiveness, and exaggerated fears of inability to care for oneself.

avoidant personality disorder

A personality disorder characterized by social withdrawal rooted in extreme fear of rejection and feelings of inadequacy.

splitting

A primitive ego defense mechanism in which the person is unable to integrate and accept both positive and negative feelings. In the view of these individuals, people—including themselves—and life situations are either all good or all bad. This trait is common in borderline personality disorder.

histrionic personality disorder

A type of personality disorder characterized by excessively emotional and attention-seeking behavior, often presented in a very colorful and dramatic fashion.

schizoid personality disorder

A type of personality disorder characterized by extreme detachment from personal relationships and restricted expression of emotions.

obsessive-compulsive personality disorder

A type of personality disorder in which the individual has an intense fear of making mistakes, which manifests in inflexible and perfectionistic behavior. It is differentiated from obsessive-compulsive disorder in that there is no evidence of the obsessive-compulsive rituals in the individual with this personality disorder.

paranoid personality disorder

A type of personality disorder in which the individual intensely mistrusts others and assumes that they have malevolent intentions toward them.

Joanne presents in the ED with complaints of suicidal ideation. The following data is collected by the nurse. Which of these assessment findings suggests that bulimia nervosa might be a health problem? Select all that apply. A. Joanne's parotid glands appears enlarged. B. Joanne's teeth have a "moth eaten" pattern of tooth decay. C. Joanne reports that she takes laxatives daily. D. Joanne's weight is within the expected range.

A,B,C,D

A patient with an eating disorder states, "I heard people laughing behind me in the check-out line at the store. I bet they thought it was hysterically funny that I gained a pound in the last few days." The nurse documents that the patient is exhibiting which cognitive distortion related to maladaptive eating regulation? 1. Magnification 2. Personalization 3. Overgeneralization 4. Dichotomous thinking

A.

Which is characteristic of the diagnosis of anorexia nervosa? A.Obsession with weight gain B.Body image disturbance C.Disregard for the feelings of others D.Healthy family relationships

AB.Body image disturbance

A nursing diagnosis of ineffective coping R/T feelings of loneliness AEB bingeing then purging when alone, is assigned to a client diagnosed with bulimia nervosa. Which is an appropriate outcome related to this nursing diagnosis? A. The client will identify two alternative methods of dealing with isolation by day 3. B. The client will appropriately express angry feelings about lack of control by week 2. C. The client will verbalize two positive self attributes by day 3. D. The client will list five ways that the body reacts to bingeing and purging.

ANS: A The ability to identify alternative methods of dealing with isolation will provide the client with effective coping strategies to use instead of bingeing and purging. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Planning | Client Need: Psychosocial Integrity

A nurse observes dental deterioration when assessing a client diagnosed with bulimia nervosa. What explains this assessment finding? A. The emesis produced during purging is acidic and corrodes the tooth enamel. B. Purging causes the depletion of dietary calcium. C. Food is rapidly ingested without proper mastication. D. Poor dental and oral hygiene leads to dental caries.

ANS: A The nurse recognizes that dental deterioration has resulted from the acidic emesis produced during purging that corrodes the tooth enamel. Excessive vomiting may also lead to dehydration and electrolyte imbalance. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Physiological Integrity

A nursing instructor is teaching students about the differences between the symptoms of anorexia nervosa and the symptoms of bulimia nervosa. Which student statement indicates that learning has occurred? A. "Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not." B. "Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients diagnosed with anorexia nervosa do not." C. "Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo, whereas clients diagnosed with anorexia nervosa do not." D. "Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients diagnosed with bulimia nervosa do not."

ANS: A The nursing student statement that clients diagnosed with anorexia nervosa experience nutritional deficits, whereas clients diagnosed with bulimia nervosa do not, indicates that learning has occurred. Anorexia is characterized by low caloric and nutritional intake. Bulimia is characterized by episodic, rapid indigestion of large quantities of food, followed by purging. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Physiological Integrity

______________________is characterized by a BMI of 17 or lower, or less than 15 in extreme cases.

Anorexia nervosa

A nurse should identify topiramate (Topamax) as the drug of choice for which of the following conditions? Select all that apply. A. Binge eating with obesity B. Bingeing and purging with a diagnosis of bulimia nervosa C. Weight loss with a diagnosis of anorexia nervosa D. Amenorrhea with a diagnosis of anorexia nervosa E. Emaciation with a diagnosis of bulimia nervosa

ANS: A, B The nurse should identify that topiramate (Topamax) is the drug of choice when treating binge eating with obesity and treating bingeing and purging with a diagnosis of bulimia nervosa. Topiramate (Topamax) is a novel anticonvulsant used in the long-term treatment of binge-eating disorder with obesity. The use of Topamax results in a significant decline in mean weekly binge frequency and significant reduction in body weight. With the use of this medication, episodes of bingeing and purging were decreased in clients diagnosed with bulimia nervosa. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies

Which nursing intervention is appropriate when caring for clients diagnosed with either anorexia nervosa or bulimia nervosa? A. Provide privacy during meals. B. Remain with the client for at least 1 hour after the meal. C. Encourage the client to keep a journal to document types of food consumed. D. Restrict client privileges when provided food is not completely consumed.

ANS: B A nurse should remain with clients diagnosed with either anorexia nervosa or bulimia nervosa for at least 1 hour after meals. This allows the nurse to monitor for food discarding (anorexia nervosa) and/or self-induced vomiting (bulimia nervosa). KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Physiological Integrity

A client who is 5 foot 6 inches tall and weighs 98 pounds is admitted with a medical diagnosis of anorexia nervosa. Which nursing diagnosis would take priority at this time? A. Ineffective coping R/T food obsession B. Altered nutrition: less than body requirements R/T inadequate food intake C. Risk for injury R/T suicidal tendencies D. Altered body image R/T perceived obesity

ANS: B Based on Maslow's hierarchy, the priority nursing diagnosis for this client must address physical needs prior to emotional considerations. This client must be immediately physically stabilized due to the life-threatening nature of his or her nutritional status. KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process: Analysis | Client Need: Safe and Effective Care Environment: Management of Care

A nurse working with a client diagnosed with bulimia nervosa asks the client to recall a time in life when food could be consumed without purging. Which is the purpose of this nursing intervention? A. To gain additional information about the progression of the disease process B. To emphasize that the client is capable of consuming food without purging C. To incorporate specific foods into the meal plan to reflect pleasant memories D. To assist the client to become more compliant with the treatment plan

ANS: B By asking the client to recall a time in life when food could be consumed without purging, the nurse is assessing previously successful coping strategies. This information can be used by the client to modify maladaptive behaviors in the present and future. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity

The family of a client diagnosed with anorexia nervosa becomes defensive when the treatment team calls for a family meeting. Which is the appropriate nursing reply? A. "Tell me why this family meeting is causing you to be defensive. All clients are required to participate in two family sessions." B. "Family intervention and support are important in your child's recovery." C. "Family dynamics are not linked to eating disorders. The meeting is to provide your child with family support." D. "Clients diagnosed with anorexia nervosa are part of the family system, and any alteration in family processes needs to be addressed."

ANS: B The nurse should educate the family on the importance of family dynamics, involvement, and support in the treatment of anorexia nervosa. Families engaging in conflict avoidance and struggling with issues of power and control may contribute to the development of this disorder or impede the progress of recovery. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity

When a community health nurse arrives at the home of a client diagnosed with bulimia nervosa, the nurse finds the client on the floor unconscious. The client has a history of using laxatives for purging. To what would the nurse attribute this client's symptoms? A. Increased creatinine and blood urea nitrogen (BUN) levels B. Abnormal electroencephalogram (EEG) C. Metabolic acidosis D. Metabolic alkalosis

ANS: C Excessive vomiting and laxative or diuretic abuse may lead to problems with dehydration and electrolyte imbalance. The nurse should attribute this client's fainting to the loss of alkaline stool due to laxative abuse, which would lead to a relative metabolic acidotic condition. KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process: Assessment | Client Need: Physiological Integrity

A morbidly obese client is prescribed an anorexiant medication. The nurse should prepare to teach the client about which medication? A. Diazepam (Valium) B. Dexfenfluramine (Redux) C. Lorcaserin (Belviq) D. Pemoline (Cylert)

ANS: C Lorcaserin was approved by the FDA in 2012. It suppresses the appetite by altering various 5-HT2C serotonin receptors. Withdrawal from anorexiants can result in rebound weight gain, lethargy, and depression. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies

Family dynamics are thought to be a major influence in the development of anorexia nervosa. Which information related to a client's home environment should a nurse associate with the development of this disorder? A. The home environment maintains loose personal boundaries. B. The home environment places an overemphasis on food. C. The home environment is overprotective and demands perfection. D. The home environment condones corporal punishment.

ANS: C The nurse should assess that a home environment that is overprotective and demands perfection may be an influence in the development of anorexia nervosa. In adolescence, distorted eating patterns may represent a rebellion against controlling and demanding parents. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity

A high school senior is diagnosed with anorexia nervosa and is hospitalized for severe malnutrition. The treatment team is planning to use behavior modification. What rationale should a nurse identify as the reasoning behind this therapy choice? A. This therapy will increase the client's motivation to gain weight. B. This therapy will reward the client for perfectionist achievements. C. This therapy will provide the client with control over behavioral choices. D. This therapy will protect the client from parental overindulgence.

ANS: C The nurse should identify that behavior modification therapy will be used because it provides the client with control over behavioral choices. Clients diagnosed with anorexia nervosa are often allowed to contract privileges based on weight gain. The client maintains control over eating and exercise. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity

A client's altered body image is evidenced by claims of "feeling fat," even though the client is emaciated. Which is the appropriate outcome criterion for this client's problem? A. The client will consume adequate calories to sustain normal weight. B. The client will cease strenuous exercise programs. C. The client will perceive an ideal body weight and shape as normal. D. The client will not express a preoccupation with food.

ANS: C The nurse should identify that the appropriate outcome for this client is to perceive an ideal body weight and shape as normal. Additional goals include accepting self on the basis of self-attributes instead of appearance and to realize that perfection is unrealistic. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Planning | Client Need: Psychosocial Integrity

A client diagnosed with bulimia nervosa has been attending a mental health clinic for several months. Which factor should a nurse identify as an appropriate indicator of a positive client behavioral change? A. The client gains 2 pounds in 1 week. B. The client focuses conversations on nutritious food. C. The client demonstrates healthy coping mechanisms that decrease anxiety. D. The client verbalizes an understanding of the etiology of the disorder.

ANS: C The nurse should identify that when a client uses healthy coping mechanisms that decrease anxiety, positive behavioral change is demonstrated. Stress and anxiety can increase bingeing, which is followed by inappropriate compensatory behaviors. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity

A group of nurses are discussing how food is used in their families and the effects this might have on their ability to work with clients diagnosed with eating disorders. Which of these nurses will probably be most effective with these clients? A. The nurse who understands the importance of three balanced meals a day B. The nurse who permits children to have dessert only after finishing the food on their plate C. The nurse who refuses to engage in power struggles related to food consumption D. The nurse who grew up poor and frequently did not have enough food to eat

ANS: C The nurse who refuses to engage in power struggles related to food consumption will probably be most effective when dealing with clients diagnosed with eating disorders. Because of this attitude the nurse recognizes that the real issues have little to do with food or eating patterns. The nurse will be able to focus on the control issues that precipitated these behaviors. KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity

A nurse is seeing a client in an outpatient clinic for treatment of anorexia nervosa. Which is the most appropriate, correctly written short-term outcome for this client? A. The client will use stress-reducing techniques to avoid purging. B. The client will discuss chaos in personal life and be able to verbalize a link to purging. C. The client will gain 2 pounds prior to the next weekly appointment. D. The client will remain free of signs and symptoms of malnutrition and dehydration.

ANS: C The symptoms of anorexia nervosa do not include purging. Correctly written outcomes must be client centered, specific, realistic, and measurable and also include a time frame. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Planning | Client Need: Physiological Integrity

A client diagnosed with bulimia nervosa is to receive fluoxetine (Prozac) by oral solution. The medication is supplied in a 100-mL bottle. The label reads 20 mg/5 mL. The doctor orders 60 mg q day. Which dose of this medication should the nurse dispense? A. 25 mL B. 20 mL C. 15 mL D. 10 mL

ANS: C Twenty mg of Prozac multiplied by three results in the calculated 60-mg daily dose ordered by the physician. Each 5 mL contains 20 mg. Five mL multiplied by three equals the liquid dosage of 15 mL. KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process: Implementation | Client Need: Physiological Integrity: Pharmacological and Parenteral Therapies

A nurse responsible for conducting group therapy on an eating disorder unit schedules the sessions immediately after meals. Which is the best rationale for scheduling group therapy at this time? A. To shift the clients' focus from food to psychotherapy B. To prevent the use of maladaptive defense mechanisms C. To promote the processing of anxiety associated with eating D. To focus on weight control mechanisms and food preparation

ANS: C When the nurse schedules group therapy immediately after meals, the nurse is addressing the emotional issues related to eating disorders that must be resolved if these maladaptive responses are to be eliminated. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Implementation | Client Need: Psychosocial Integrity

Women x2

Are men or women more likely to have binge eating disorder?

Why are behavior modification programs the treatment of choice for clients diagnosed with eating disorders? A. These programs help clients correct distorted body image. B. These programs address underlying client anger. C. These programs help clients manage uncontrollable behaviors. D. These programs allow clients to maintain control.

ANS: D Behavior modification programs are the treatment of choice for clients diagnosed with eating disorders because the programs allow clients to maintain control. Issues of control are central to the etiology of these disorders. Behavior modification techniques aid in restoring healthy body weight. KEY: Cognitive Level: Application | Integrated Processes: Planning | Client Need: Psychosocial Integrity

A potential Olympic figure skater collapses during practice and is hospitalized for severe malnutrition. Anorexia nervosa is diagnosed. Which client statement best reflects a theory about the underlying etiology of this disorder? A. "I was just trying to be like everyone else." B. "All the skaters on the team are following an approved 1,200-calorie diet." C. "When I lose skating competitions, I also lose my appetite." D. "I am angry at my mother. I can get her approval only when I win competitions."

ANS: D This client statement reflects a possible underlying etiology of anorexia nervosa. The client is expressing feelings about family dynamics that may have influenced the development of this disorder. Families who are overprotective and perfectionistic can contribute to a family member's development of anorexia nervosa. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Evaluation | Client Need: Psychosocial Integrity

A client diagnosed with anorexia nervosa stopped eating 5 months ago and lost 25% of total body weight. Which subjective client response would the nurse assess to support this medical diagnosis? A. "I do not use any laxatives or diuretics to lose weight." B. "I am losing lots of hair. It's coming out in handfuls." C. "I know that I am thin, but I refuse to be fat!" D. "I don't know why people are worried. I need to lose this weight."

ANS: D When the client states, "I don't know why people are worried. I need to lose this weight," the client is exhibiting the subjective response of ineffective denial. This client is minimizing symptoms and is unable to admit impact of the disease on life patterns. The client does not perceive personal relevance of symptoms or danger. KEY: Cognitive Level: Application | Integrated Processes: Nursing Process: Assessment | Client Need: Psychosocial Integrity

· More the 15% of expected body weight is considered what eating Disorder

Anorexia Nervosa

Jane is hospitalized on the psychiatric unit. She has a history and current diagnosis of bulimia nervosa. Which of the following symptoms would be congruent with Jane's diagnosis? a. Binging, purging, obesity, hyperkalemia b. Binging, purging, normal weight, hypokalemia c. Binging, laxative abuse, amenorrhea, severe weight loss d. Binging, purging, severe weight loss, hyperkalemia

B

John has sought help for his concern that he is binge eating, and he feels it has "gotten out of control." He asks the nurse what can be done to help him. Which of the following is the most accurate responses? A. "There is nothing that can be done." B. " There are some medications and psychological treatments that have demonstrated effectiveness in reducing binge eating disorders." C. "The primary problem is obesity. I can help you set up a calorie-restricting diet." D. "There are medications that can help with weight loss, but there are no medications effective for reducing binge eating."

B

Nancy, age 14, has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refusing to eat. What is the primary nursing diagnosis for Nancy? a. Complicated grieving b. Imbalanced nutrition: Less than body requirements c. Interrupted family processes d. Anxiety (severe)

B

a. "You know that if you don't eat, you will die." b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube." c. "You might as well leave if you are not going to follow your therapy regimen." d. "You don't have to eat if you don't want to. It is your choice."

B

What is in Cluster C In personaility disorder

Behaviors described as anxious or fearful a. Avoidant personality disorder b. Dependent personality disorder c. Obsessive-compulsive personality disorder

What is in Cluster B In personaility disorder

Behaviors described as dramatic, emotional, or erratic a. Antisocial personality disorder b. Borderline personality disorder c. Histrionic personality disorder d. Narcissistic personality disorder

What is in Cluster A In personaility disorder

Behaviors described as odd or eccentric a. Paranoid personality disorder b. Schizoid personality disorder c. Schizotypal personality disorder

What Ages Does Anorexia Nervous start

Between 12-30

Anorexia tends to present at an earlier age, whereas bulimia presents at a later age.

Between Bulimia and anorexia, which presents at younger ages?

A hospitalized client with bulimia nervosa has stopped vomiting in the hospital and tells the nurse she is afraid she is going to gain weight. Which is the most appropriate response by the nurse? a. "Don't worry. The dietitian will ensure you don't get too many calories in your diet." b. "Don't worry about your weight. We are going to work on other problems while you are in the hospital." c. "I understand that you are concerned about your weight and we will talk about good nutrition; but now I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment." d. "You are not fat, and the staff will ensure that you do not gain weight while you are in the hospital, because we know that is important to you."

C

Some obese individuals take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated with use of amphetamines that makes this practice undesirable? a. Bradycardia b. Amenorrhea c. Tolerance d. Convulsions

C

Which medication has been used with some success in clients with anorexia nervosa? a. Lorcaserin (Belviq) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Carbamazepine (Tegretol

C

Which of the following physical manifestations would you expect to assess in Nancy? a. Tachycardia, hypertension, hyperthermia b. Bradycardia, hypertension, hyperthermia c. Bradycardia, hypotension, hypothermia d. Tachycardia, hypotension, hypothermia

C

2.Which assessment finding would the nurse expect to find in clients diagnosed with bulimia? A.They are below normal weight. B.They binge when they experience hunger. C.They will be highly motivated to seek help D.They are within their normal weight range.

D.They are within their normal weight range.

Persistent eating of non-nutritive substances for at least 1 month. Eating is inappropriate for age of pt Eating is not culturally supported

Define Pica

Repeated regurgitation of food for at least 1 month Regurgitation is not due to a medical condition Does not occur during Bulimia , Anorexia, BED or avoidant/restrictive food intake disorder.

Define Rumination Disorder

Recurrent binge eating episodes where a large volume of food is consumed in a short period of time These episodes are associated with a sense of loss of control, followed by guilt or shame, which leads to compensatory purging behaviors.

Describe Bulimia Nervosa

Bradycardia, hypotension, palpitations, fatal arrythmias, cardiovascular decompensation.

Describe some of the cardiovascular complications that can present secondary to Anorexia Nervosa

Anorexia Binge/purge - - Low body weight is maintained. - - More risk averse, less likely to abuse drugs, alcohol and are more 'tightly' wound Bulimia Binge/purge - - Normal body weight maintained. - - More likely to abuse drugs/alcohol, more likely to be sexually active, more likely to be impulsive.

Describe the difference between Anorexia binge/purge type and Bulimia binge/purge type? Discuss the personality characteristics (likelihood to engage in risky behaviors)?

binge-eating disorder (BED)

Eating disorder characterized by recurrent episodes of consuming large amounts of food during which the person feels a lack of control over eating.

Mild (1-3 episodes per week) Moderate (4-7 episodes per week) Severe (8-13 episodes per week) Extreme (14+)

How do you 'rank' the severity of Bulimia Nervosa?

A client is 5′8′′ tall and weighs 105 pounds. The client has been taking laxatives daily and self-induces vomiting after eating. Which is the priority nursing diagnosis for this client? A.Ineffective denial B.Disturbed body image C.Low self-esteem D.Imbalanced nutrition, less than body requirements

Imbalanced nutrition, less than body requirements

When Does Beliuma Nervous Start What Age

Later in life late teens

What Are the Cause for Hospitalization may be necessary from an eating disorder.

Malnutrition Dehydration Severe electrolyte imbalance Cardiac arrhythmia or severe bradycardia Hypothermia Hypotension Suicidal ideation

__________________is defined as a BMI of 30 or greater.

Obesity

Russell's Sign

Pt's with Bulimia will present with scratches and build up of extra skin on their knuckles from inducing vomiting. What is this sign called?

§ Hypothalamus Is a major factor in

Regulates hunger

Personality

The totality of emotional and behavioral characteristics that are particular to a specific person and that remain somewhat stable and predictable over time.

Mood swings, kleptomania Self Harm, Substance abused, suicide attempts Frequent trips to bathroom after eating

What are some 'associated' behavioral features that you will see with Bulimia Nervosa? (That are generally unique to BN, not AN)

Underweight (loss of 15% of ideal body weight) Lanugo * Fine hair growth over entire body Thinning Hair Amenorrhea HA, fainting, preoccupation with food or calories Cold intolerance, brittle hair, dry skin, poor circulation Bradycardia, heart failure, kidney failure Anemia, constipation, diarrhea Low Libido, infertility Osteopenia Muscle wasting/loss

What are some Physical Signs of Anorexia?

Fluid and electrolyte abnormalities (Hypochloremic, hypokalemic Alkalosis) Hypovolemia Secondary hypoaldosteronism Cardiac Arrhythmia

What are some severe Medical Complications that can occur secondary to Bulimia Nervosa?

1 episode weekly for 3 months

What are the 'frequency' requirements for a bulimia Nervosa diagnosis?

Misuse of laxatives or diuretics Self induced vomiting Over Exercising or fasting

What are the three compensatory behaviors Bulimic patients use to relieve their guilt via purging following binging?

Antihistamine Olanzapine TCA or SRI

What are the three mainstay Rx for treating Anorexia Nervosa?

Unipolar Major Depression Specific Phobia

What are the two most common psychiatric comorbidities of Bulimia (both at 50%)?

It has similar food issues but IS NOT BASED ON DISTORTED BODY IMAGE OR WEIGHT CONCERNS

What defines ARFID (Avoidant Restrictive Food Intake Disorder) from Bulimia/Anorexia ?

Meets diagnostic criteria but without weight loss of

What is Atypical Anorexia?

Fine hair growing over entire body

What is Lanugo?

Chipmunk Cheeks from enlarged salivary glands

What is a unique facial feauture of Bulimia Nervosa?

Criteria Met but without frequency or duration

What is atypical Binge Eating Disorder?

Fluoxetine, long half life, so if they vomit the pill, the half life is so long that they are Gucci

What is the best med to use in Bulimia Nervosa, and why?

Topirimate is the best RX (Decreased binge occurrences and weight loss) ( ASE = HA and paresthesias) **Fluoxetine is not that good, no better than CBT by itself + CBT & IPT

What is the best treatment for Binge Eating Disorder?

Hypochloremic, hypokalemic alkalosis

Which acid base disturbance may indicate Bulimia Nervosa?

refeeding syndrome

a series of negative intracellular electrolyte shifts associated with aggressive renourishment in a malnourished patient, poses a risk for hypophosphatemia, hypokalemia, hypocalcemia, and hypomagnesemia.

amenorrhea

absence of menstruation

bulimia nervosa

an eating disorder characterized by episodes of overeating, usually of high-calorie foods, followed by vomiting, laxative use, fasting, or excessive exercise

anorexia nervosa

an eating disorder in which an irrational fear of weight gain leads people to starve themselves

What is the Maudsley approach?

an evidence-based program for the treatment of adolescents with AN *modifies the concept of the patient being in control

Disturbed body image/low self-esteem

confusion in mental picture of one's physical self" confusion in mental picture of one's physical self"

binging

eating large amounts of food in a short amount of time under 2 hours

purging

engaging in behaviors such as vomiting or misusing laxatives to rid the body of food

lanugo

fine, soft hair, especially that which covers the body and limbs of a human fetus or newborn.

object constancy

he phase in the separation/individuation process when the child learns to relate to objects in an effective, constant manner. A sense of separateness is established, and the child is able to internalize a sustained image of the loved object or person when out of sight.

Complicated grieving

is defined as "a disorder that occurs after the death of a significant other [or any other loss of significance to the individual], in which the experience of distress accompanying bereavement fails to follow normative expectations and manifests in functional impairment"

A BMI range for ___________ weight is 20 to 24.9.

normal

emaciated

unnaturally thin

What Can Excessive Vomiting, laxative and Diuretic abuse may cause?

· Dehydration · Electrolyte Imbalance

How do people with Beliuma Nervous feel that promote this behavior

· Depression · anxiety · substance abuse

what are Phycial Symptoms of Anorexia Nervosa

· Hypothermia · Bradycardia · Hypotension · Edema · Lanugo · Metabolic Changes · Amenorrhea ( girls)

what feeling do people with Anorexia Nervosa have

· Obsession with food · Anxiety · Depression

How do people with Beliuma Nervous rid themself of extra calories ?

· Vomiting · Laxatives · Diuretics · Enemas · Excessive Excise Fasting or Excessive excise