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Eating DisordersPsychiatric Nursing: Contemporary Practice

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What is the psychological theory for why anorexia nervosa develops?
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Failure in the key tasks of separation-individuation and autonomy are interrupted resulting in delays in development. Also, fear of adult sexuality results in self-starvation
What event has been shown to trigger the onset of anorexia nervosa?
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Dating
What is the prevalent social theory for why anorexia nervosa develops?
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Media and other social influences glamorize thin builds and creates a innate dissatisfaction. To cope, girls diet and overexercise.
What act was linked to the development of eating disorders, higher weight concerns, loneliness, poor self-perception and higher preference for sedentary/isolative activities?
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Teasing
What family characteristics have been linked to anorexia nervosa?
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High enmeshment (intensity of interactions), overprotectiveness, rigidity, conflict avoidance, and strong ethical or religious code
What are the risk factors for anorexia nervosa?
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Dieting despite weight loss, increase in BMR, overexercising, fear of weight gain, perfectionism, low self-esteem, body dissatisfaction, weight gain during puberty, society's focus on ideal body type.
What factors were found to provide resilience or protection against development of anorexia nervosa?
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Academic achievement, family connectedness, emotional well-being, and positive self-esteem.
What are the components of the female athlete triad of symptoms of anorexia nervosa?
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Disordered eating, menstrual dysfunctions and Low BMI
What parental behaviors have been linked to eating disorders?
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Low affection, communication, and little time spent with the child.
What are the treatment focuses for patients with anorexia nervosa?
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Nutrition rehabilitation, electrolyte & fluid balance, resolving body image conflicts, increasing coping skills, assisting family with healthy communication and functioning.
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What is needed in most cases to restore weight in patients with anorexia nervosa?
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Hospitalization
When do intensive therapies to treat anorexia nervosa typically begin (at what point in treatment)?
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After the refeeding phase is complete
What type of program is typically used to encourage patients with anorexia nervosa to put on the needed weight?
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Privilege earning programs that rewards visits with family, outings, etc. based on weight gain
Why do a lot of interventions to treat communication, coping, body images, etc. occur after the refeeding treatment for anorexia nervosa?
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Concentration is usually impaired in severly malnourished patients with anorexia nervosa.
What class of medications are not effective during the acute phase of anorexia nervosa and prescribed cautiously during the initiation phase of treatment due to their side effect of weight loss?
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SSRIs
At what point is hospitalization required for patients with anorexia nervosa?
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When their body weight is less than 75% of the ideal, their blood pressure/heart rate are low, their glucose is less than 60, their potassium is less than 3 mEq/L or they are dehydrated or have other fluid and electrolyte imbalances.
What are the ideal characteristics of the communication approach when working with patients with anorexia nervosa?
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Be firm, accepting, provide rationales for all interventions, be consistently nonreactive.
What is the usual criteria for hospital discharge for patients with anorexia nervosa?
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Achievement of 85% of their ideal body weight, and BMI of 19-25.
What is the most important intervention during the initial stage of treatment of anorexia nervosa?
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Refeeding. The nurse must monitor and record all intake carefully.
What is the desired amount of weekly weight gain for patients who are hospitalized with anorexia nervosa?
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1-2 lbs.
What is included in the behavioral plan as part of a weight-increasing protocol for patients who are hospitalized with anorexia nervosa?
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Positive reinforcements in the form of excursion passes, family visits, negative reinforcements in the form of bed rest along with the understanding that the reinforcements aren't punitive.
  
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