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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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NURS 663 EXAM 2024 |Questions andAnswers | 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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