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Anorexia and Bulimia
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Bulimia Nervosa
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anorexia,bulimia,obesity
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Bulimia Nervosa Notes
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Eating Disorders and Bulimia
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*DSM- Bulimia Nervosa
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Bulimia Nervosa Notes
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Bulimia Nervosa Summary
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Chapter Eleven: Eating Disorders
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Treatment of Eating Disorders
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Epidemiology Section Learning Objectives Describe the epidemiology of anorexia nervosa. Describe the epidemiology of bulimia nervosa. Describe the epidemiology of binge eating disorder. 10.2.1. Anorexia Nervosa207 Fundamentals of Psychological Disorders According to the National Eating Disorder Alliance (NEDA) website, at any point in time more women (0.3-0.4%) than men (0.1%) will be diagnosed with anorexia. Anorexia nervosa is most prevalent in postindustrialized, high-income countries such as the United States, Australia, New Zealand, Japan, and many European countries. In the U.S., prevalence is lower among Latinx and non-Latinx Black Americans than non-Latinx Whites (APA, 2022). 10.2.2. Bulimia Nervosa According to the NEDA website, at any point in time, 1.0% of women and 0.1% of men will meet the diagnostic criteria for bulimia nervosa. A study by Stice and Bohon (2012) found that between 1.1% and 4.6% of females and 0.1% to 0.5% of males will develop bulimia and that subthreshold bulimia occurs in 2.0% to 5.4% of adolescent females. The DSM reports that the 12-month prevalence ranges from 0.14% to 0.3% with higher rates in females and high-income countries. Rates are similar across ethnoracial groups across the U.S. (APA, 2022). 10.2.3. Binge Eating Disorder Hudson et al. (2007) reports that BED is three times more common than anorexia and bulimia and is more common than breast cancer, HIV, and schizophrenia. It has also been found that between 0.2% and 3.5% of females and 0.9% and 2.0% of males will develop binge eating disorder with subthreshold binge eating disorder occurring in 1.6% of adolescent females (Stice & Bohon, 2012). The DSM reports a 12-month prevalence of 0.44% to 1.2% with rates 2-3 times higher in women, similar rates across ethnoracial groups in the United States and between most high-income industrialized countries (APA, 2022). For more on statistics and research related to feeding and eating disorders, please visit the National Eating Disorders Association website below: https://www.nationaleatingdisorders.org/statistics-research-eating-disorders Key Takeaways You should have learned the following in this section: BED is three times more common than anorexia and bulimia. All feeding and eating disorders are more common in women and high-income, industrialized countries. Only anorexia shows differences across ethnoracial groups in the United States.208 Fundamentals of Psychological Disorders Section 10.2 Review Questions 1. Which feeding and eating disorder is most common? 2. What gender differences occur with regards to the eating disorders? 3. Are there any other noteworthy similarities or differences in the prevalence rates of the three disorders? 10.3. Comorbidity Section Learning Objectives Describe the comorbidity of anorexia nervosa. Describe the comorbidity of bulimia nervosa. Describe the comorbidity of BED. 10.3.1. Anorexia Nervosa Anorexia is rarely a single diagnosis. High rates of bipolar, depressive, and anxiety disorders are common among individuals with anorexia nervosa. Obsessive-compulsive disorder is more often seen in those with the restricting type of anorexia nervosa, whereas alcohol use disorder and other substance use disorders are more commonly seen in those with anorexia who engage in binge-eating/purging behaviors. Unfortunately, there is also a high rate of suicidality, with rates reported to be 18 times greater than in an age- and gender-matched comparison group. It is also estimated that between 9% and 25% of individuals with anorexia have attempted suicide (APA, 2022). 10.3.2. Bulimia Nervosa The majority of individuals diagnosed with bulimia nervosa also present with at least one other mental disorder. Similar to anorexia nervosa, there is a high frequency of depressive symptoms (i.e., low selfesteem), as well as bipolar and depressive disorders. While some experience mood fluctuations because of their eating pattern (occurring at the same time or following the development of bulimia), some individuals will identify mood symptoms prior to the onset of bulimia nervosa (APA, 2022). Anxiety, particularly social anxiety, is often present in those with bulimia nervosa. However, most mood and anxiety symptoms resolve once an effective treatment of bulimia is established. Substance use disorder, and in particular alcohol use disorder, is also prevalent in those with bulimia, with about a 30% prevalence among those with bulimia. The substance abuse begins as a compensatory behavior (e.g., stimulant use is used to control appetite and weight) and over time, as the eating disorder209 Fundamentals of Psychological Disorders progresses, so does the substance abuse. There is also a percentage of individuals with bulimia nervosa who display personality features that meet the criteria for at least one personality disorder, most often borderline personality disorder. Finally, about one-quarter to one-third of individuals with bulimia have had suicidal ideation and a comparable amount have attempted suicide. 10.3.3. BED Research shows that BED shares similar comorbidities with anorexia nervosa and bulimia nervosa. Common comorbidities include major depressive disorder and alcohol use disorder. About 25% of those with BED have shown suicidal ideation (APA, 2022). Key Takeaways You should have learned the following in this section: Anorexia has a high comorbidity with bipolar, depressive, and anxiety disorders. OCD and alcohol use disorder are also comorbid but depend on the type of anorexia (restricting or bingeeating/purging). Bulimia has a high comorbidity with bipolar disorder, depressive symptoms and disorders, social anxiety, and substance use disorder. BED is highly comorbid with MDD and alcohol use disorder. There is a high rate of suicidal ideation with all three disorders.
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También la lluvia (Bolivia)
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Pueblos Indígenas de Bolivia
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Chapter 19 Evaluation – Apply to all chapters – Once you implement a intervention -you need to assess whether it worked or not---- equals = EVALUATE whether it worked, --- Do I need to change the intervention, do I need to modify the intervention or do I say it worked = met the evaluation -- I achieved the outcome I was looking for. Chapter 20- Read over the terminology at the beginning. Very important terms. What does it mean to document and why is it so important? What does the patient record contain? What are the characteristics of effective documentation? What is the purpose of privacy and confidentiality? What happens if you do not follow those rules? READ over Box-20-1, what does HIPAA stand for? Glance at the abbreviations but we will go over !! Delegation is important when it comes to documentation - working with Nursing assistants - must follow all policies of what NA can chart/ LVN's and what the RN will chart . Need to know job description and duties!! For quality performance improvement how important is documentation? Types /Methods of documentation - Electronic EHR records, source oriented records, problem- oriented medical records = SOAP charting , PIE, focus charting, charting by exception, . Models of charting = CASE Management, collaborative, unusually occurrence, … Nursing documentation - Assessments, care plan, patient care summary - area charting- critical care, progress notes, flow sheet=graphic record. MAR, acquity, discharge/transfer, Home health documentation AMA, Nurses reporting to each other at the change of shift = change of shift report=Handoff reports , calling doctors, transferring patients < Incident reports. Chapter 30 -Medication Chapter: Administering medications is very important- understanding terminology is first- what do all the terminology mean and why? Pharmacology, pharmokinetics, pharmacist( knowing their responsibility - Prinicipals of pharmacology what/why do we need to understand nomenclature of drugs? Generic vs. trade, What are the different types of drugs ? why is that important? What is the importance of drug classification? Again what is Drug indications mean? Versus action of drug? How do the mechanics of drugs interfer with drug action? Pharmokinetics! What does the word Bioavailability mean? What are the different types of Drug reactions and how do they differ?( adverse, allergic, toxic, idiosyncratic). What type of factors can affect Drug action: ( developmental, weight, cultural/genetic, psychological, environmental, timing)- More terminology – half life, why do we need to know that? Can you give an example of that? Peak and trough -again what is the importance of collecting a peak and trough and demonstrate or explain how to do both? Principles of medication- medications prescriptions and orders. You need to know what an order is , what is included on an order what are the details of importance about the order ( what are the components on the order). What are different types of orders and can you describe the difference of how they work? Who can write orders? Are there rules to for checking orders and questioning orders? Know your math for medication . what are the rights to medication( there are a lot but ) which are the most important up front. Now, apply the Nursing Process to this chapter- what type of problems can the patient demonstrate while starting med, taking meds or . Here is a question-"Pharmacokinetics question type" – medication administered that are renal toxic should have what frequent assessment of which blood values: WBC, Ptt, BUN , creatinine, glucose. chapter 33 Skin/wounds- What is the function of the skin, layers of the skin- after that understand why I am asking you to know those functions and sites. Because you need to think how deep and where the wound is and what it looks like. Assess the wound : type clean/dirty, acute/chronic, intentional/unintentiona. How does a wound heal: phases of healing,- look at each phase- and recognize a specific details to know about that phase. What are complications of wounds? What do they mean? And if they happen what will the nurse do to assist the patient to over come their complication. What are factors to develop wounds? What different factors that can actually create or assist in the development of a wound? What do you look for when you are ASSESSING-(patient responses)- color, size, smell, location, drainage =color-what are colors and names of drainage? , amount, smell, - terminology-maceration, evisceration, fistula, tunneling, - . Pressure wounds- what are they? how do they develop? How do you know it is a pressure wound? Are there stages of a pressure wound? How do you tell the difference- again, look at specific detail!! ( earlier I asked you about the layers of the skin)!!!! How do we take care to of pressure ulces (wounds)???? What are some Nursing Interventions that can be done by nurse to prevent pressure wounds and how do care for them once they have developed and how do we slow them down to not progress to the next stage.?? Critical think -- what is important to take care of a wound. How do help people heal a wound. Can you create a pressure wound in 1-day??What are some colors of a pressure wound? What do the colors mean? If we need to debride a wound-- what does debridement mean? What types of debridement are there? ( autolytic, mechanical, enzymatic, sharp) --How do you know a wound is infected? What does a nurse need to do to check for an infection? How do they collect a specimen. lastly , Utilizing the Nursing process in this chapter-- and referring to Chapter 15 also -- when you have skin broken--- what type of Nursing diagnosis would you use to label the patients wound response???? Look over the different type of Nursing diagnosis. How does Heat and Cold help a patient and what problems could develop from either heat or cold. Chapter-text-37 Nutrition Chapter- what is the purpose of reading the labels on store items, what is the GI tract function? What is the function of the esophagus , stomach, small intestine, large colon, rectum and anus? What does a nutrient mean? How much of fat, Carbs , protein, ? Food label look it over. Look over the PLATE Food!! Why is nutrition so important? How does it help the patient? Why is this an important intervention to assess. How do you assess a patients nutritional status? What does Positive or Negative Nitrogen Balance mean? Anorexia Nervosus means what ? Anorexia means what ? Bulemia? What is malnutrition? How much weight can you lose that is steady and good to lose? Look at some labs: Albumin, Prealbumin, Cholesterol, triglycerides, CBC, SMA7=Na+, K+, cl, co2, gluc BUN, CREAT, Mg, CA. : Types of Diet- NPO, Ice chips, clear liquid, full liquid, puree diet, mechanical diet, - renal diet, liver diet, cardiac diet- what is included in the diet ( each of these diets) ie- what can you eat to get your potassium? To give you eyes nutrition? Pharmacology Book: (enteral/Parenteral chapter)-first what is the difference between enteral and parenteral nutrition? Under Enteral Nutrition- what is a the purpose of a salem sump tube versus a soft silastic tube with a wire in it? What is the primary purpose for each tube. What is the direction of how to place an nasogastric tube in position? How do we verifiy it is in the correct position. What are some management of care towards the nasogastric tube. What are some problems/complications having a nasogastic tube. Ok , we started tube feeding, what are some complications with starting tube feeding to someone who hasn’t had any food in awhile . If there is any complications from tube feeding how do you handle them? What is Parenteral Nutrition ? What is PPN vs. TPN. What is the primary ingredient in the PPN or the TPN? What are complications with TPN nutrition? How does Enteral Nutrition compare to Parenteral (TPN) Nutrition? What are some complications from TPN nutrition? Pharmacology Book : Vitamins/minerals vitamins and minerals - fat soluble and water soluble how do they differ? What is important about each vitamin? What should you teach your patient about these meds. Which meds can be toxic? What is important about IRON, what is important about Ferrous . How did the two differ? ( read very carefully for the difference)
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Çeviri bilimi
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