Eating disorders, Cognitive disorders

Anorexia physical problems:

• __________

• Constipation

• Cold intolerance

• Lanugo hair on body

• Loss of body fat

• Muscle atrophy

• Hair loss

• Dry skin

• Dental caries

• _______ edema

• Bradycardia, arrhythmias

• Orthostasis

• Enlarged parotid glands and hypothermia

• Electrolytes imbalance

Amenorrhea, pedal

Bulimia weight is usually

Normal

Anorexia and Bulimia Biologic factors

•Genetic vulnerability

•Disruptions in the nuclei of the _________ relating to hunger and satiety

•Neurochemical changes (norepinephrine, serotonin); not known if these changes cause disorders or are result of eating disorders

Hypothalamus

Anorexia and Bulimia Developmental factors:

• No ________ , bc of enmeshment (lack of clear boundaries) with family

• Cultural belief

• Body image disturbance

Control

Anorexia Nervosa

•Onset usually between the ages of 14 and 18

•Denial early on; depression and _______ with progression; isolation; medical complications

•Treatment: often difficult; client is resistant, uninterested, denies problem

Lability

Can promote weight gain in clients with anorexia nervosa

Amitriptyline, Cyproheptadine

Antipsychotic effect on bizarre body image distortions and weight gain,

Problematic side effects

Olanzapine

Anorexia

Ssris may have effectiveness but need

Close monitoring for weight loss

Bulimia Nervosa

•Onset: late adolescence or early adulthood (average age of 18–19 years)

•Binge eating frequently begins during or after dieting

•Possible restrictive eating between binges

•Clients aware eating behavior is pathologic; go to great lengths to hide

Treatment

•_______ most effective

CBT

Bulimia nervosa

Psychopharmacology: antidepressants

Desipramine, imipramine, amitriptyline, nortriptyline, ________, __________

Phenelzine, fluoxetine

Difficulty identifying and expressing feelings

Alexithymia

Do not ask pt w anorexia if they are sad, instead ask them to

Describe feelings

Raise client awareness, regain sense of control, dairy of all food eaten

Bulimia self monitoring

Therapy most effective for anorexia

Family

Syndrome involving disturbance of consciousness with change in cognition

Usually develops over short period

Etiology: almost always results from identifiable physiological, metabolic, or

cerebral disturbance or disease or from drug intoxication or withdrawal

Delirium

Delirium meds

Sedation, antipsychotic

Delirium appearance and Motor behavior:

Restless, speech problems

Delirium mood and affect

Unpredictable mood shifts

Delirium thought process and content

Disorganized, fragmented

Initial sign of delirium is an

Altered loc

Delirium judgment and insight

Impaired

Delirium roles and relationships

Inability to fulfill

Delirium self-concept

Frightened

Delirium physiological considerations

Disturbed sleep wake cycles, fail to perceive internal body cues

Delirium

Managing client’s confusion:

______________ (calling by name, referring to time of day or expected activity); speaking in low, clear voice; use of touch;

avoiding sensory overload

Orienting cues

Deterioration of language function

Aphasia

Impaired ability to execute motor functions despite intact motor abilities

Apraxia

Inability to recognize or name objects despite intact sensory abilities

Agnosia

Repeating words or sounds over and over

Palilalia

Only dementia that has abrupt onset

• Rapid changes w plateau

Vascularized dementia

Medications for degenerative dementias:

____________ like donezepil

cholinesterase inhibitors