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NSG 3450 MENTAL HEALTH UNIT 6 AND 7 EXAM
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NSG 3450 MENTAL HEALTH UNIT 6AND 7 EXAM
Anorexia nervosa
Pt. refused to maintain a height-appropriate weight and voiced extreme anxiety of
gaining weight. It is a fluctuating chronic sickness. The patient will need long-term
treatment.
Subtypes of Anorexia Nervosa
Restricting and binge-eating or purge kind
Characteristics of Anorexia Nervosa
Extreme Weight Loss
An intense dread of losing control and gaining weight.
This involves a strong denial of the problem.
Typically well-educated and financially secure
distorted body image.
Restricted calories with significantly reduced BMI.
More prevalent among females.
Perfectionist; competitive personality.
Dysfunctional family dynamics: domineering mother.
Clinical features of anorexia nervosa
Low weight.
Amenorrhea
,Yellow skin.
Lanugo
Cold extremities.
Peripheral edema
Muscle weakness.
Very hesitant to get help.
Perfectionist inclinations.
Abnormal lab results in anorexia nervosa
Hypokalemia (<3.5 mEq/L)
Anaemia, pancytopenia.
Reduced bone density
Areas to consider when evaluating an anorexic patient (psychological)
Perception of the Problem
Eating Habits
History of Dieting
Methods for weight control (restricting, excessive exercise, purging)
The value is assigned to a certain size and weight.
Interpersonal and social function
Mental state and physiological parameters
Refeeding Syndrome
,metabolic changes that may occur after the nutritional replenishment of starving
patients. This leads to improper fluid balance, aberrant glucose metabolism,
hypophosphatemia, and hypomagnesemia.
Interventions for Anorexia Nervosa patients
-Ensure that the patient has a one-on-one worker at all times.
-Scheduled meal times
-Make the patient feel accepted in the environment.
-Restrict the patient from conducting any exercise.
-Restrict bathroom use following meals.
-Handle discussions concerning physical appearance carefully.
-Weigh the patient after the first void, wearing the same clothes every day.
-The goal is to gain 2 pounds weekly.
-The patient must eat the food ordered.
-Provide more calories
-Small, frequent meals to prevent refeeding syndrome.
-The emphasis should be on eating habits and underlying sentiments of worry.
Bulimia nervosa.
A disorder in which cycles of overeating are followed by some sort of purging or
cleaning of the digestive tract, either through vomiting or compensatory techniques
such as diuretics or laxatives, fasting, or extreme exercise.
The DSM-5 criteria for bulimia nervosa
, - Repeated instances of binge eating
-Repeated compensatory measures to prevent weight gain, such as vomiting
-Eating a large amount of food in a short period of time, which is far larger than
what most people would consume in the same amount of time under similar
conditions.
-A feeling of being out of control while eating throughout the episode.
-Binge eating and incorrect compensatory behaviors occur at least once a week for
three months.
-Body form and weight have an unreasonably strong influence on self-evaluation.
Clinical evaluation of a bulimia nervosa patient.
-At or near the appropriate body weight.
-Enlargement of parotid glands.
- Dental erosion and caries
-Impulsive and compulsive tendencies
-Gastric dilation and rupture.
-Russell's sign: calluses and scars on hand.
- Peripheral edema
-Muscle weakness
-Abnormal test results (hypokalemia, hyponatremia)
-Cardiomyopathy
-ECG alterations
Cardiac failure (due to cardiomyopathy caused by ipecac overdose).
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