Eating Disorders Chapter 14

Which therapy is most helpful to patients diagnosed with eating disorders to address problems associated with emotional dysregulation? A. Dialectical Behavioral Therapy B. Family Therapy C. Group Therapy D. Psychodynamic Therapy

A Rationale: Dialectical behavioral therapy is a form of cognitive behavioral therapy adapted to address problems associated with emotional dysregulation. Family therapy is especially efficacious in early-onset and short-duration anorexia. It supports parent refeeding of children and identifies family dynamics that may be contributing to the problem. Group therapy offers support to patients who feel isolated while offering an arena in which to explore the eating disorder. Psychodynamic therapy explores the underpinnings of the disorder.

Which pharmaceutical treatment is considered the "gold standard" for bulimia nervosa? A. Fluoxetine B. Olanzapine C. Benzodiazepine D. Anticonvulsant

A Rationale: Fluoxetine has been approved by the Food and Drug Administration (FDA) for the treatment of bulimia nervosa and has been regarded as the "gold standard" in the treatment of this disorder. Olanzapine, a second-generation antipsychotic, is increasingly being reported in the literature to positively affect weight gain and improve cognition and body image for anorexia nervosa. Benzodiazepine and anticonvulsant therapies are not specifically indicated for eating disorders.

Which factor explains why a patient diagnosed with bulimia nervosa should be carefully assessed for the presence of dental caries? A. Excessive Vomiting B. Binge Eating C. Ipecac Intoxication D. Excessive Daily Caloric Intake

A Rationale: In bulimia nervosa, induced vomiting causes reflux of hydrochloric acid over the tooth enamel, which leads to dental caries. Binge eating can cause gastric dilation or rupture, not dental caries. Ipecac intoxication can cause cardiac failure, not dental caries. Excessive caloric intake paired with purging can lead to the patient having slightly low to normal body weight.

Which clinical finding is expected with a patient diagnosed with anorexia nervosa? Select all that apply. One, some, or all responses may be correct. A. Dry Skin B. Emaciation C. High Blood Pressure D. Decreased Urine Output E. Decreased Urinary Concentration

A, B, D Rationale: Anorexia nervosa causes imbalance in nutrition leading to dehydration and dry skin. It can also lead to emaciation. In some patients, fluid intake is also decreased, leading to decreased urine output. Patients with anorexia nervosa usually have low blood pressure caused by deficiency of proteins. The low urinary output results in increased concentration of urine.

Which clinical manifestation is identified as a symptom of anorexia nervosa? Select all that apply. One, some, or all responses may be correct. A. Emaciation B. Russell's Sign C. Dehydration D. Yellow Skin E. Hyperkalemia

A, C, D Rationale: Anorexia nervosa is an eating disorder in which the patient has intense fear of weight gain and refuses to maintain optimal weight. Because of malnourishment and starvation, the patient is emaciated and dehydrated. The skin is yellow as a result of elevated carotene levels in the blood. Patients with bulimia nervosa have Russell's sign, or calluses and scars on the hand caused by self-induced vomiting; this is not typically associated with anorexia nervosa. Hypokalemia, as opposed to hyperkalemia, is present in patients with anorexia nervosa because of dehydration.

Which sign or symptom would the nurse expect a patient with a diagnosis of binge-eating disorder (BED) to exhibit? Select all that apply. One, some, or all responses may be correct. A. Anxiety B. Obesity C. Purging D. Laxative use E. Russell's Sign

B. Obesity Rationale: BED is a type of compulsive overeating in which the patient presents with obesity. Patients with BED report depression, not anxiety. Purging, laxative use, and Russell's sign are noted with bulimia nervosa

Which term describes the growth of fine, downy hair on the face and back of a patient diagnosed with anorexia nervosa? A. Amenorrhea B. Russell's Sign C. Carotenemia D. Languo

D Rationale: Lanugo is the growth of fine, downy hair on the face and back. Amenorrhea is the abnormal absence of menstruation. Russell's sign is a callus on the knuckles from self-induced vomiting. Carotenemia is elevated carotene levels in the blood resulting in skin with yellow pallor.

A patient has been prescribed fluoxetine for the treatment of bulimia nervosa. Which assessment would the nurse perform related to this treatment? Select all that apply. One, some, or all responses may be correct. A. Mood B. Weight C. Vital Signs D. Suicide Risk E. Body Mass Index

All. Rationale: The nurse would assess the response to the medication by assessing the patient's mood, weight, vital signs, and body mass index. Fluoxetine carries an increased risk for suicide, so the nurse would assess for suicidal ideation.

Anorexia Nervosa

An eating disorder characterized by an obstinate and willful refusal to eat, a distorted body image, and an intense fear of gaining weight

Which statement is true of patients diagnosed with bulimia nervosa? A. They exhibit languo B. They severely restrict their food intake C. They often appear to have a normal weight D. They binge eat but do not engage in compensatory measures

C. They often appear to have a normal weight Rationale: Patients diagnosed with bulimia are often at or close to ideal body weight and do not appear physically ill. Lanugo and severely restricting food intake are associated with anorexia nervosa. Binge eating without engaging in compensatory measures is a behavior characteristic of binge eating disorder.

Harm-Reduction Approach

Goal is to improve quality of life and minimize harm through symptoms, management, skill development, an understanding of the benefits an risk of symptoms

Cognitive Distortions

Inaccurate and irrational automatic thoughts or ideas that lead to false assumptions and misinterpretations.

Eating Disorders

Severe disturbances in eating behavior, high levels of anxiety around eating, significant disturbance in the perception of body shape and weight

Purging

The use of vomiting, laxatives, excessive exercise, restrictive dieting, enemas, diuretics, or diet pills to compensate for food that has been eaten and that the person fears will produce weight gain

Bulimia Nervosa

an eating disorder characterized by episodes of overeating, followed by vomiting, laxative use, fasting, or excessive exercise

Ideal Body Weight

an estimate of what a person should weigh, calculated by using body mass index as a reference guide

Languo

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

Refeeding Syndrome

metabolic alterations that may occur during nutritional repletion of starved patients

Cachetic

severely underweight with muscle wasting

Binge Eating Disorders

significant binge-eating episodes, followed by distress, disgust, or guilt, but without the compensatory purging or fasting that marks bulimia nervosa

A teenager is underweight compared to others in a similar age and height category. During an assessment interview, the nurse finds that the teen has a fear of gaining weight and is refusing to eat. Which disorder does the nurse suspect the health care provider will diagnose? A. Binge Eating B. Rumination Disorder C. Bulimia Nervosa D. Anorexia Nervosa

D. Rationale: Anorexia nervosa refers to intense fear of weight gain and refusal of food to maintain weight. Binge eating involves repeated episodes of overindulgence in eating followed by a feeling of guilt and distress but no compensatory behavior. Rumination disorder is characterized by regurgitation, followed by rechewing, reswallowing, or spitting. Bulimia nervosa involves repeated episodes of binge eating followed by inappropriate compensation behaviors, including induced vomiting or purging.