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Eating DisordersPsychiatric Nursing: Contemporary Practice

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What is the criteria for a diagnosis of bulemia nervosa?
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Episodes of purging, binging or restriction that occur at least twice a week for 3 monnths or more.
What are the primary focus of interventions to treat patients with bulemia nervosa?
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The primary focus is on the dietary restraint of patients with bulemia nervosa
If a patient is a purging type bulemic that uses vomiting to eliminate food, what acid/base imbalance is associated?
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Metabolic alkalosis
If a patient is a purging type bulemic that uses laxatives to eliminate food, what acid/base imbalance is associated?
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Metabolic acidosis
How does a binge eating disorder differ from bulemia nervosa?
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The patients don't purge to compensate for the binges and don't restrict their diet. Most are obese.
What medications have been found to be effective for binge eating disorder?
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Sertraline, topiramate
What is the typical age of onset for bulemia nervosa?
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18-24
What are the most common comorbidities with bulemia nervosa?
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Substance abuse, substance dependence, depression and OCD.
What neurochemical is shown to be significantly reduced in patients with bulemia nervosa?
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Serotonin
What amino acid has been linked to a depressed mood, desire to binge, and increased weight and shape concerns when plasma levels are low in patients with bulemia nervosa?
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Tryptophan, a precursor to serotonin
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Chronic depletion of __________ is thought to be one of the major mechanisms whereby persistent dieting leads to the development of eating disorders.
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Tryptophan
What are common family characteristics of patients with bulemia nervosa?
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Chaotic, few rules, unclear boundaries, overly close relationship between the mother and daughter.
What are the major treatment focuses for bulemia nervosa?
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Stabilizing and normalizing eating, healthy boundary setting, recolving any separation-individuation conflicts.
What are the usual treatment modalities for bulemia nervosa?
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Cognitive behavioral therapy, interpersonal therapy, nutrition counseling, SSRIs (Zoloft) or fluoxetine/Prozac
Why is family therapy not a usual part of treatment for patients with bulemia nervosa?
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The patients are usually in college, away from home or living on their own.
T/F Even though patients with bulemia nervosa may purge, to ensure a therapeutic relationship and clear boundaries, a nurse should not follow them into the bathroom.
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False, bathroom visits should be supervised in order to prevent purging.
When used to treat bulemia nervosa, what time of day should fluoxetine/Prozac or sertraline/Zoloft be taken and why?
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In the morning to prevent the drugs from impacting sleep
CBT and IPT are typical treatment modalities for bulemia nervosa. Which is usually started first and why?
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CBT is started first because the response is quicker, and it's important to address distorted thinking to correct the underlying problem.
_________ is a tool used in CBT where a patient with bulemia nervosa uses a diary and records binges and purges, precipitating emotions and environmental cues. If is then used to suggestion alternative responses which can then be reinforced.
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Self-monitoring
What are the focuses of psychoeducation for patients with bulemia nervosa?
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How to set boundaries and establish healthy limits, develop assertiveness, nutritional concepts, and clarifying misconceptions about food.
Why is group therapy beneficial for patients with bulemia nervosa?
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It is cost-effective, increases learning more so than individual therapy.
  
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