LATEST NUR 256 FINAL EXAM WORKSHEET

LATEST NUR 256 FINAL EXAM WORKSHEET Describe Clinical Manifestations (what do they look like, their vitals, what comment will they make, their labs), interventions, and Therapies. Labs to focus on for eating disorders: ECG, albumin, all electrolyte (potassium, sodium). Know Personality traits for eating disorder 1. Anorexia Nervosa • They are very obsessive, they feel like they have to be a certain way which is their perception of how they should be when no one else is asking. • This is influenced by environment factors, stress, Their Characteristics: • Intense fear of weight gain, distorted body image, restricted calories with significantly low BMI • Subtypes: restricting (no consistent bulimic features), binge/eating/purging type (primarily restriction, some bulimic behaviors) • They don’t think they have a problem, they fail to keep a good BMI Clinical Presentation: • Low weight due to caloric restriction and excessive exercise • Lanugo. And cold extremities due to starvation • Abnormal labs due to starvation (low triiodothyronine, low thyroxine levels) • Cardiovascular abnormalities due to electrolyte imbalance and dehydration (hypotension, bradycardia, heart failure) • Hypokalemia (3.5) due to starvation Intervention • Acute Care: patient will be admitted into a facility when they are in crisis • Suicidal ideation: determine if this is present before anything else, while doing this you will need to build trust with the patient before you can move forward with treatment Treatment: • Psychosocial:. Begin refeeding process, introduce patient into the milieu to group therapy and determine underlying cause of eating disorder. There are no meds, but once patient have reach 75% of their ideal body weight (BMI 20-25) that is when the nurse can consider giving them an SSRI to help manage their symptoms of OCD. Usually it is Fluoxetine (Prozac) as it is very effective tor treating OCD • The goal of therapy is to teach them how to look at food as a healthy thing and it is there to sustain life, and that it is a requirement for healthy leaving. 2. Bulimia Nervosa • They look healthy, but really they are binging and purging. They may ask for help. The reason they purge is because they have a euphoric feeling after that so they binge and then they make themselves vomit Their Characteristics: • Recurrent episode of uncontrollable binging • Inappropriate compensatory behaviors: vomiting, laxatives, diuretics, or exercise • Self-image largely influenced by body image Physical sign • They have a lot of dental caries from all of the gastric acid, they have issues with GERD, they have a lot of GI issues which is all due to the acid from vomiting • Electrolyte imbalance • Inability to maintain stable relationship, so we must watch them socially, are they avoiding people • They also have that Obsessive compulsive feeling to them not so much like that perfectionism as anorexia