anorexia nervosa
Terms
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- D/o can be life threatening, fears of gaining wt,disturbed body image,is postmenopausal(amenorrhea:3 cycles),15%wt loss,low met rate?
- Anorexia nervosa
- Name characteristics of client with Anorexia nervosa?
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1.perfectionist
2.sport/profession req thinness
3.disregard trad.femininity
4.lack of A.tissue
5.Hirsutism
6.low choles/sugar
7.chronic/progressive disease - What is the process of AN?
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1.r/o med problems(CA,TB,HIV)
2.r/o drug abuse - Assessment of a client with AN reveals?
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1.obsession with food
2.enjoys cooking for others
3.obsessed with exercise
4.feels anxious/out of control
5.distorted body image:sees themselves as fat
6.reasons for anorexia - Cardinal sign when assessing a female pt who lost wt and 15% or less under ideal wt?
- Amenorrhea(3 cycles)
- Repeated episodes of uncontrolled eating also known as compulsive over eating=obesity?
- Binge eating disorder
- A person with Binge-eating d/o may experience?
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1.anxiety
2.depression
3.low self esteem
4.poor body image
5.guilt and self disgust - Why do clients eat so much? are they hunger all the time?
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1.Not assoc with hunger
use food to:
calm and nurture(love) coping mechanism for anxiety - binging usually large amounts of soft,easily digested foods client does this?
- secretively
- Assessment of client with bing eating d/o?
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Assess for psychological factors,low SE,anger,guilt
-attemts to lose wt
-uses food as subs.for love
-med hx:due to meds
- - Which theory stated: unconscious conflicts, regression, fear of sexuality maturity?
- Psychoanalytic theory: Freud
- Theory implies, anorexia is a rejection of feminine form and attemt to regain body of child?/
- psychoanalytic theory:Freud
- Theory implies compulsive over eating -due to unmet oral needs during infancy, feels empty,?
- psychoanalytic theory:freud
- theory implies their is unconscious intra/interpersonal conflicts in family?
- Family systems
- Anorexic fam, has what expectations on child and what are the consequences?
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-overly compliant child
-conflict b/w enslavemnt/autonomy -
Hallmark is loss of control
-physical dependency
-psychological dependency - Substance dependence
- need more of the substance to get same effect?
- tolerance
- DSM criteria for substance abuse?
-
one or more in 12mt period
1.recurrent use/role failure
2.creates physical hazard con
3.legal problems
4.disturbed interperson.rltnsp - Physiological response when drug is withdrawn, assoc with tolerance?
- Withdrawal
- Occurs when a person has become tolerant to one fam of chemicals and becomes tolerant to the effects of other similar drugs?
- cross-tolerance
- Biopsychosocial theories of substance use?
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alcohol proceeds in phases:loss of control
genetic vulnerability
Neuro defects(ADHD) - Rescues the chemically dependent person from consequences of their behavior?
- Codependent
- effects of alcoholisM?
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depression
malnourished
loss of self-respect - Name minor withdrawal sx of alcoholism?
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anxiety
agitation
irritability
n/v - Name major w/d sx of ETOH?
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life threatening
HTN
high HR
confused
tremors
hallucinations
seizures - What makes alcohlism a disease?
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1.biological
2.primary
3.progressive
4.chronic
5.fatal - whats the med.tx for alcoholism?
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1.V/s frequently
2.F/E balance
3.mag.sulf(prevent seizures)
4.dilantin(hx of seizures)
5.Vit:thiamine/mult vit(B)
6.BDZs to prevent SZ &DT
7.librium/valium - Name amphetamine intoxication symptoms?
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1.energetic/euphoric
2.wt loss
3.altered judgment
4.dilated pupils
5.Rowdy
6.paranoid
7.psychoses - Name amphetamine withdrawal symptoms?
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1.depression
2.fatigue
3.restless
4.no sleep
5.suicidal
6.crashing:depression - Barbiturate intoxication?
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euphoric
relaxed
helps with sleep - barbiturate withdrawal?
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life threatening
decrease respiration
seizures
coma/insomnia
anxiety - Opioid/narcotic intoxication?
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drowsy
out of touch
euphoric
impaired memory
pin point pupils - opioid/narcotic withdrawal?
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diaphoresis
cramping
flu like ss
dilated pupils
muscle/joint pain - Cocaine intoxication?
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agitation
dilated pupils
htn,high HR, talkative, - cocaine withdrawal?
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severe cramping
fatigue
agitation
hyper insomnia - what health care providers at risk?
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Nurses
codependence
stressful work environment
self medicated
known behaviors of abuse
self awareness - Nursing attitudes toward clients with substance use d/o?
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help with self awareness
health and relationships
-self knowledge(countertransference) - Common defense mechanism of substance use d/o?
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denial
projection
rationalization - Treatment for withdrawal?
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1.safety
2.provide sitter if needed
3.monitor v/s
4.seizure precaution
5.point out reality
6.adjust room lights
7.monitor I/O
8. do not restrain - HALT common in clients that relapse stands for?
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hungry
angry
lonely
tired - Meds for clients that relapse?
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Naltrexone(Revia
disulfram(antabuse)
acamprostate(Campral) - Treatment approaches for client with substance use d/o?
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1.confrontation
2.referral and self help grps
3.life style changes:cope mec
4.intervention
5.educate - co-occurring d/o?
- mental illness and substance abuse d/o
- who is higher risk for substance abuse?
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mentally ill (Axis 1)
antisocial/borderline(axis 2) - Treatment for client with dual dx?
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antidepressants(ssris)
2nd generation antipsychotics - with dual dx what anti anxiety meds is preffered?
- Buspar, klonopin
- co-existing problems seen in the E.D?
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1.drunk-suicidal
2.chronic cocaine use-suicide attemt/M.I or CVA
3.Cocaine crash:severe depression
4.stimulants:hallucinations - Assessment of client with substance use d/o?
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be non judgmental
ask open ended questions
look for denial in pt
appearances:v/s neuro,toxic screen - What substance should not be used with prescribed meds?
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stimulant:speed,cocaine
depressants
marijuana/hallucinogenics
tobacco -
treatment model
1.sequential?
2.parallel?
3.intergraded?
Most accepted principle? -
1.most severe d/o tx 1st
2.tx d/o simultaneosly
3.one program provides both
abstinence - Nursing care must take into account:
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-socialization
-relapse prevention
-suicide precaution