Comprehensive Guide to Eating and Feeding Disorders
School
Maryville University**We aren't endorsed by this school
Course
NURS 665
Subject
Nursing
Date
Dec 10, 2024
Pages
5
Uploaded by jtruong918
NURS 663 SU 22 Exam 2 Review Exam 2 • Mostly multiple choice, 2 short answer questions • Covering content from: • 6: Eating disorders • 7: Feeding disorders • 8: Sleep disorders • 9: Aging process and depression in the elderly • 10: Alzheimer’s disease and other dementias Feeding and Eating Disorders The signs, symptoms, and DSM-5 criteria for and be able to distinguish among: • Anorexia nervosa • Binge eating disorder • Bulimia nervosa • Pica • Rumination disorder • Avoidant/restrictive food intake disorder The standard medication treatments and recommended therapy/therapeutic techniques for: • Anorexia nervosa • Binge eating disorder • Bulimia nervosa Anorexia Nervosa “RID” R – Restriction of intake leading to significantly low body weight I - Intense fear of weight gain D - Disturbance in perception of one's weight or body image 2 subtypes • Restricting Type – extreme diet, fasting,excessive exercise • Binge/Purge Type – self-induced vomiting, laxative abuse, diuretic abuse, laxative abuse, enemas Severity based on BMI Mild (>17) Moderate (16-16.99) Severe (15-15.99) Extreme (<15) Bulimia Nervosa “Bulimics Over-Consume Pastries” B – recurrent Binge episodes (1x/wk x 3mo’s) O – Out of control overeating C – excessive Concern with body shape/weight P – Purging or other compensatory behaviors Severity based on # of episodes/wk: Mild – 1-3/wk Mod – 4-7/wk Severe – 8-13/wk Extreme – 14+/wk
Tx: Lisdexamfetamine dimesylateBinge Eating Disorder “Binge-eaters Overeat” B – recurrentBinge episodes (1x/wk x 3mo’s) O – Out of control overeating Plus 3 or more of the following: Fast past Full Feast when not Famished Flushed and Flustered and Feeling Disgusted • Severity based on # of episodes/wk: • Mild – 1-3/wk • Mod – 4-7/wk • Severe – 8-13/wk • Extreme – 14+/wk Tx: SSRIs (Fluoxetine) Pica P: Pallor, Poor motor/mental development, Psychological problems, Pregnancy, Poverty, Poisoning (lead) I: Iron deficiency/Iron treatment, Insults during neonatal period, Infection, Intestinal obstruction C: Clay/Chalk/Cigarettes/, Cravings (non-nutritive), Chronic abdominal pain A: Age (2y/o minimum), Anemia (differential), Autism (differential) Feeding Disorders: Pica Diagnosis — The DSM-5 diagnosis of pica requires each of the following: • Repeated eating of nonfood substances (chalk, clay, cloth, coal, dirt, gum, hair, metal, paint, paper, pebbles, soap, string, or wool) that are not nutritional, for at least one month. • The eating behavior is inappropriate to the patient’s developmental level, and is not culturally supported or socially normal. • If the eating behavior occurs in the context of another mental disorder (eg,
autism, intellectual disability, or schizophrenia) or general medical condition (including pregnancy), the severity of the eating behavior warrants additional clinical attention. Treatment of Pica • Order a full physical and screen for missing nutrients as well as other medical issues, such as anemia, lead poisoning, and so on • Control for behavior and environmental factors. • Therapy would include CBT. Daily logs and examine if there is an association of eating nonfood items and a trigger (anxiety, and so on).• Seek to reduce the impulse to eat abnormally with pharmacological interventions. Rumination Disorder Diagnosis — The DSM-5 diagnosis of rumination disorder requires each of the following: • Repeated regurgitation of food, which may be rechewed, reswallowed, or spit out; the eating disturbance occurs for at least one month. • Regurgitation of food is not due to a general medical condition, such as gastroesophageal reflux disease or pyloric stenosis. • Regurgitation does not occur solely during the course of avoidant/restrictive food intake disorder, anorexia nervosa, binge eating disorder, or bulimia nervosa. • If the eating behavior occurs in the context of another mental disorder (eg, intellectual disability) or general medical condition (including pregnancy), the severity of the eating behavior warrants additional clinical attention. • Distinguish between sleep/wake disorders such as: o Insomnia Disorder o Hypersomnia o Kleine-Levin Syndrome • Mechanism of action, risks/benefits, and major patient education points for medications used to treat sleep/wake disorders Avoidant/Restrictive Food IntakeDisorder Diagnosis — The DSM-5 diagnosis of avoidant/restrictive food intake disorder requires each of the following: • Avoiding or restricting food intake, which may be based upon lack of interest in food, the sensory characteristics of food, or a conditioned negative response associated
with food intake following an aversive experience (eg, choking). The eating behavior leads to a persistent failure to meet nutritional and/or energy needs, manifested by at least one of the following: 1. Clinically significant weight loss, or in children, poor growth orfailure to achieve expected weight gain 2. Nutritional deficiency 3. Supplementary enteral feeding or oral nutritional supplements are required to provide adequate intake 4. Impaired psychosocial functioning • The eating or feeding disturbance is not due to lack of available food or associated with a culturally sanctioned practice. • The disturbance does not occur solely in the course of anorexia nervosa or bulimia nervosa, and body weight and shape are not distorted. • The disturbance is not due to a general medical condition (eg, gastrointestinal disease, food allergies, or occult malignancy) or another mental disorder. When avoidant/restrictive food intake disorder occurs in the context of another illness, the eating disturbance is both out of proportion to what is expected for the other illness and warrants additional clinical attention. Sleep/Wake Disorders 10 disorder groups: 1. Insomnia disorder 2. Hypersomnolence disorder 3. Narcolepsy 4. Breathing-related sleep disorders 5. Circadian-rhythm sleep disorders 6. NREM sleep arousal disorders 7. REM sleep behavior disorders 8. Nightmare disorder 9. Restless leg syndrome 10. Substance/medication-induced sleep disordersolriamfetol Aging and Depression in the Elderly • Explain the normal signs of aging and memory performance. • Common interview techniques/questions and patient responses to screening for suicide of older adults (such as stages of grief responses). • Explain and distinguish grief, from MDD and persistent complex bereavement disorder, including the DSM-5 criteria for each.Alzheimer’s and other dementias • Explain the screening tools for dementia, Alzheimer’s, and
neurocognitive disorders in the geriatric population. • The differences among Alzheimer’s disease and dementias (such as vascular, Lewy body, and frontal lobe dementia). • The mechanisms of action, risks, benefits, and medication education to provide to patientsand caregivers about the medications donepezil, memantine, and galantamine. • The risks of prescribing antipsychotics for patients with dementia. • Explain delirium, including the involved neurotransmitters and distinguishing features of patient presentation of delirium versus dementia.Delirium: ‘4A and 3C’ Disturbance in Attention and Awareness Abrupt or Acute onset with Altering in severity during the course of a day Cognitive disturbance Consequence of another medical condition or substance relatedCan’t explained byanother neuro-Cognitive disorder or Coma