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NURS 663 Exam 3 with Verified Q&A’S | Latest Update
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NURS 663 Exam 3 with Verified Q&A’S | Latest Update
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NURS 663 Exam 3 with Verified Q&A’S |Latest Update
Binge Eating Disorder
"Binge-Eaters Overeat" - ✔✔B: recurrent Binge episodes (1x/wk x 3 months)
O: Out of control overeating
Plus 3 or more of the following:
1. Eat fast past full
2. Feast when not famished
3. Flushed and flustered and feeling disgusted
Binge-Eating Disorder - ✔✔- A sense of lack of control overeating during the episode
- Occurring AT LEAST 1x per week for 3 MONTHS
- Associated with marked distress
Binge Episodes are Associated with ≥ 3 of the Following: - ✔✔- Eating more rapidly than
usual
- Eating until feeling uncomfortably full
- Eating large amounts of food when not feeling physically hungry
- Eating alone because of feeling embarrassed by how much one is eating
- Feeling disgusted with oneself, depressed or guilty afterwards
(Common for all 5 to be present)
Binge-Eating Disorder
Severity Based on # of Episodes/week - ✔✔Mild: 1-3/wk
Moderate: 4-7/wk
,Severe: 8-13/wk
Extreme: 14+/wk
Binge Eating Disorder
Pharmacological Interventions - ✔✔lisdexamfetamine (Vyvanse): Currently the only FDA
approved medication
Topiramate: Causes cognitive dysfunction when dosed for effectiveness
Anti-obesity agents target appetite and weight, but no the behavior
Naltrexone: "Hit or miss," results
Baclofen: Some evidence it reduces automatic behaviors, it can take high doses; do not abruptly
disrupt due to possible psychosis
Dasotraline: In phase 3 for BED and dual-acting DA and NE reuptake inhibitor, shows promise,
not on the market yet
Binge-Eating Disorder
Conclusion - ✔✔- Most prevalent, often not screened for
- Known as a "shameful secret"
- lisdexamefetamine (Vyvanse) only FDA-approved medication
Bulimia Nervosa and BED
Treatment - ✔✔- Individual therapy, dynamic psychotherapy, behavioral interventions (CBT)
(stay with patient 2-3 hours after they eat to ensure no vomiting)
- Stepped care to facilitate CBT
- SSRIs and CBT: mixed reviews
Bulimia nervosa & BED
Overconcern With Shape and Weight - ✔✔Bulimia nervosa: Overconcern about shape and
weight required for diagnosis
,BED: Not part of the diagnosis criteria, although frequently present
Bulimia Nervosa & BED
Presence of Compensatory Behaviors - ✔✔Bulimia nervosa: Regular compensatory behaviors
BED: No regular compensatory behaviors
Bulimia Nervosa & BED
Behavioral Indicators for Binge Eating - ✔✔Bulimia Nervosa: Not part of diagnostic criteria
BED: Required for diagnosis
Bulimia Nervosa & BED
Distress About Binge Eating - ✔✔Bulimia nervosa: Not part of diagnostic criteria
BED: Marked distress about binge eating
Bulimia Nervosa & BED
Both Include - ✔✔- Loss of control
- Binge eating frequently
- Duration of binge eating: Both require a duration of at least 3 months
Anorexia Nervosa Physical Exam Findings
V/S - ✔✔Bradycardia
Hypotension with marked orthostatic changes
Hypothermia
, Poikilothermia
Anorexia Nervosa Physical Exam Findings
General - ✔✔Muscle atrophy
Loss of body fat
Anorexia Nervosa Physical Exam Findings
CNS - ✔✔Generalized brain atrophy with enlarged ventricles
Decreased cortical mass
Seizures
Abnormal electroencephalogram
Anorexia Nervosa Physical Exam Findings
CV - ✔✔Peripheral (starvation) edema
Decreased cardiac diameter
Narrowed left ventricular wall
Decreased response to exercise demand
Superior mesenteric artery syndrome
Anorexia Nervosa Physical Exam Findings
Renal - ✔✔Prerenal azotemia
Anorexia Nervosa Physical Exam Findings
Hematologic - ✔✔Anemia of starvation
Leukopenia
Hypocellular bone marrow
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