eating disorders; anorexia, bulimia, binge, refeeding

anorexia nervosa BMI

17-18 extremely underweight

anorexia nervosa is what type of disorder?

Ego syntonic disorder they like who they are

anorexia nervosa patient presentation (6)

intense fear of gaining weight, extreme distorted body image, excessive exercise, laxative or thyroid medication use, and perfectionism

anorexia nervosa physical symptoms (7)

not eating, vomiting, hypothermia, bradycardia (40s), chronic decreased BP, lanugo, no menstrual cycle

nursing interventions for anorexia nervosa (3)

achieve a safe body weight, schedule group therapy after meals, stick to strict schedule with meals

Treatment for anorexia nervosa

there are no drugs approved to treat core symptoms, meds used to treat comorbidities are SSRIs, antianxiety agents, mood stabilizers, second gen antipsychotics (to gain weight)

bullimia nervosa BMI

20-26 normal weight

what type of disorder is bulimia nervosa?

Ego dystonic disorder because the vomiting compensatory mechanism they are embarrassed by their actions 

patient presentation bulimia nervosa (7)

binge eating followed by self induced vomiting, misuse of laxatives, diuretics, poor dental hygiene, enlarged parotid glands, russell sign, potassium imbalance

Treatment meds for bulimia nervosa (5)

SSRIs fluoxetine (Prozac), sertraline (zoloft), paroxetine (Paxil), citalopram (Celexa), mood stabilizers

therapy treatment for bulimia nervosa

CBT, Mixed methods for refractive cases, DBT is the best one

Binge eating disorders patient presentation

recurrent episodes of uncontrollable binging without compensatory behaviors which induces guilt, depression, embarrassment, or disgust

binge eating weight

overweight or obese

treatment for binge eating

lisdexamfetamine dimesylate (Vyvanse) is the only FDA approved medication its a stimulant that can cause weight loss

refeeding syndrome

Malnourished individuals start eating again and overflow their system , can cause MI or death

refeeding syndrome happens within?

first 5 days of refeeding

weight gain should not excess how many pounds due to refeeding syndrome?

5 pounds a week could cause overload, 1-2 pounds a week is safe

electrolyte imbalances caused by refeeding syndrome?

hypophosphatemia, hypokalemia, hypomagnesia

signs and symptoms of refeeding syndrome (8)

weakness, exhaustion, disorientation, memory loss, trouble swallowing, trouble breathing (can trigger pulmonary edema), vision changes, organ dysfunction 

risk factors for refeeding syndrome (5)

anorexia, bulimia, uncontrolled diabetes, overuse of antacids, and diuretics

treat ment for refeeding syndrome

replace micronutrients first, then body will be prepared to metabolize carbs

electrolyte imbalance complications of bulimia nervosa

persistent vomiting (metabolic alkalosis), increased laxative use (metabolic acidosis), hypokalemia, hyponatremia (from persistent vomitting)

persistent vomiting can cause? (3)

tooth enamel erode, choking risk, seizures

increased laxative use can cause?

incontinence

hyponatremia, hypokalemia from persistent vomiting can cause?

EKG changes, cardiomyopathy