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NURS 663 EXAM 2024 |Questions and Answers | Answers 100% Correct and Verified

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NURS 663 EXAM 2024 |Questions and Answers | Answers 100% Correct and Verified

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  • September 27, 2024
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NURS 663 EXAM 2024 |Questions and
Answers | Answers 100% Correct and Verified

Bulimia Nervosa & Binge Eating and Purging Type Anorexia Nervosa Physical Exam Findings

Metabolic - ✔✔Hypokalemic alkalosis or acidosis
Hypochloremia
Dehydration


Bulimia Nervosa & Binge Eating and Purging Type Anorexia Nervosa Physical Exam Findings

Renal - ✔✔Prerenal azotemia
Acute and chronic renal failure


Bulimia Nervosa & Binge Eating and Purging Type Anorexia Nervosa Physical Exam Findings

CV - ✔✔Arrhythmias
Myocardial toxicity from emetine (ipecac)


Bulimia Nervosa & Binge Eating and Purging Type Anorexia Nervosa Physical Exam Findings

Dental - ✔✔Lingual surface enamel loss
Multiple carries


Bulimia Nervosa & Binge Eating and Purging Type Anorexia Nervosa Physical Exam Findings

GI - ✔✔Swollen parotid glands
Elevated serum amylase levels
Gastric distention
Irritable bowel syndrome
Melanosis coli from laxative abuse

,Bulimia Nervosa & Binge Eating and Purging Type Anorexia Nervosa Physical Exam Findings

Musculoskeletal - ✔✔Cramps
Tetany



Carotenemia - ✔✔Yellowing of skin. Sclera remains white.



Hypertrophy of salivary glands - ✔✔Patient's who purge. Looks like chipmunk



Russell's sign - ✔✔Scarring or calluses on the dorsum of the hand secondary to self-induced
vomiting



Lanugo - ✔✔fine downy hair



Pica - ✔✔- Repeated eating of nonfood substances that are not nutritional, for AT LEAST 1
MONTH
- Inappropriate to developmental level and not culturally/socially normally
- If occurs in the context of another mental disorder or general medical condition, the severity
of the eating behavior warrants additional attention



Pica Causes - ✔✔Can be iron, zinc, or calcium deficiency


Both clay and starch can bind to iron in the GI tract, exacerbating the deficiency.



Pica mneumonic - ✔✔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 (2 y.o. minimum), Anemia (differential), Autism (differential)



Dangers of Pica - ✔✔- Liver and kidney damage, electrolyte disturbance resulting in cardiac
arrythmias and seizures
- Toxic poisoning (such as lead-based paint, mercury poisoning)
- Internal damage caused by sharp items (intestinal obstruction)
- Parasites or intestinal infections from soil
- Internal blockage and constipation
- Damage to teeth
-Nutritional deprivation



Pica Tx - ✔✔-Full physical, screen for missing nutrients, and other medical issues (anemia,
lead poisoning)
-Control behavior and environmental factors
-CBT (positive reinforcement, modeling, behavior shaping, over-correction treatment)
-Parent education (attention, stimulation, nurtring)
- Daily logs (association with triggers [anxiety])
-Reduce impulse to eat abnormally with pharmacological interventions
- - Impulsivity/compulsivity -> SSRIs, stimulants



Rumination Disorder - ✔✔- Repeated regurgitation of food for AT LEAST 1 MONTH
- Regurgitation of food is not due to a general medical condition
- Does not occur during the course of avoidant/restrictive food intake disorder, anorexia
nervosa, binge eating disorder, or bulimia nervosa
- If occurs in the context of another mental disorder or general medication condition, the
severity warrant additional clinical attention

, Rumination Disorder

Diagnostic features - ✔✔- "at least several times per week, typically daily"
- NO involuntary retching, NO nausea, NO disgust
- Afterward: rechew, reswallow, or spit out
- Onset is 1 hour after eating


Rumination Disorder

Functional Consequences - ✔✔Restrictive eating and avoidance of social eating


Rumination Disorder

Medical Consequences - ✔✔Malnutrition and weight loss


Rumination Disorder

Causes - ✔✔- May occur following a viral illness, emotional stress, or physical injury
- While the initial stressor improves, and altered sensation in the abdomen persists. This
ultimately results in the relaxation of the muscle at the bottom of the esophagus. To relieve this
discomfort people with this disorder use abdominal wall muscles to expel and regurgitate foods
- As a result of the relief of symptoms, the person repeats the same response when the
discomfort returns. Overtime the person unconsciously adopts this learned behavior.



Rumination Disorder TX - ✔✔Parent education
Habit reversal training
Pharmacology treat symptoms (anxiety, mood disorders)


Rumination Disorder

Treatment - ✔✔- Strategies: relaxation (massage therapists), diaphragmatic breathing, and
biofeedback

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