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51 Cards in this Set

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D/o can be life threatening, fears of gaining wt,disturbed body image,is postmenopausal(amenorrhea:3 cycles),15%wt loss,low met rate?
Anorexia nervosa
Name characteristics of client with Anorexia nervosa?
1.perfectionist
2.sport/profession req thinness
3.disregard trad.femininity
4.lack of A.tissue
5.Hirsutism
6.low choles/sugar
7.chronic/progressive disease
What is the process of AN?
1.r/o med problems(CA,TB,HIV)
2.r/o drug abuse
Assessment of a client with AN reveals?
1.obsession with food
2.enjoys cooking for others
3.obsessed with exercise
4.feels anxious/out of control
5.distorted body image:sees themselves as fat
6.reasons for anorexia
Cardinal sign when assessing a female pt who lost wt and 15% or less under ideal wt?
Amenorrhea(3 cycles)
Repeated episodes of uncontrolled eating also known as compulsive over eating=obesity?
Binge eating disorder
A person with Binge-eating d/o may experience?
1.anxiety
2.depression
3.low self esteem
4.poor body image
5.guilt and self disgust
Why do clients eat so much? are they hunger all the time?
1.Not assoc with hunger
use food to:
calm and nurture(love) coping mechanism for anxiety
binging usually large amounts of soft,easily digested foods client does this?
secretively
Assessment of client with bing eating d/o?
Assess for psychological factors,low SE,anger,guilt
-attemts to lose wt
-uses food as subs.for love
-med hx:due to meds
-
Which theory stated: unconscious conflicts, regression, fear of sexuality maturity?
Psychoanalytic theory: Freud
Theory implies, anorexia is a rejection of feminine form and attemt to regain body of child?/
psychoanalytic theory:Freud
Theory implies compulsive over eating -due to unmet oral needs during infancy, feels empty,?
psychoanalytic theory:freud
theory implies their is unconscious intra/interpersonal conflicts in family?
Family systems
Anorexic fam, has what expectations on child and what are the consequences?
-overly compliant child
-conflict b/w enslavemnt/autonomy
Hallmark is loss of control
-physical dependency
-psychological dependency
Substance dependence
need more of the substance to get same effect?
tolerance
DSM criteria for substance abuse?
one or more in 12mt period
1.recurrent use/role failure
2.creates physical hazard con
3.legal problems
4.disturbed interperson.rltnsp
Physiological response when drug is withdrawn, assoc with tolerance?
Withdrawal
Occurs when a person has become tolerant to one fam of chemicals and becomes tolerant to the effects of other similar drugs?
cross-tolerance
Biopsychosocial theories of substance use?
alcohol proceeds in phases:loss of control
genetic vulnerability
Neuro defects(ADHD)
Rescues the chemically dependent person from consequences of their behavior?
Codependent
effects of alcoholisM?
depression
malnourished
loss of self-respect
Name minor withdrawal sx of alcoholism?
anxiety
agitation
irritability
n/v
Name major w/d sx of ETOH?
life threatening
HTN
high HR
confused
tremors
hallucinations
seizures
What makes alcohlism a disease?
1.biological
2.primary
3.progressive
4.chronic
5.fatal
whats the med.tx for alcoholism?
1.V/s frequently
2.F/E balance
3.mag.sulf(prevent seizures)
4.dilantin(hx of seizures)
5.Vit:thiamine/mult vit(B)
6.BDZs to prevent SZ &DT
7.librium/valium
Name amphetamine intoxication symptoms?
1.energetic/euphoric
2.wt loss
3.altered judgment
4.dilated pupils
5.Rowdy
6.paranoid
7.psychoses
Name amphetamine withdrawal symptoms?
1.depression
2.fatigue
3.restless
4.no sleep
5.suicidal
6.crashing:depression
Barbiturate intoxication?
euphoric
relaxed
helps with sleep
barbiturate withdrawal?
life threatening
decrease respiration
seizures
coma/insomnia
anxiety
Opioid/narcotic intoxication?
drowsy
out of touch
euphoric
impaired memory
pin point pupils
opioid/narcotic withdrawal?
diaphoresis
cramping
flu like ss
dilated pupils
muscle/joint pain
Cocaine intoxication?
agitation
dilated pupils
htn,high HR, talkative,
cocaine withdrawal?
severe cramping
fatigue
agitation
hyper insomnia
what health care providers at risk?
Nurses
codependence
stressful work environment
self medicated
known behaviors of abuse
self awareness
Nursing attitudes toward clients with substance use d/o?
help with self awareness
health and relationships
-self knowledge(countertransference)
Common defense mechanism of substance use d/o?
denial
projection
rationalization
Treatment for withdrawal?
1.safety
2.provide sitter if needed
3.monitor v/s
4.seizure precaution
5.point out reality
6.adjust room lights
7.monitor I/O
8. do not restrain
HALT common in clients that relapse stands for?
hungry
angry
lonely
tired
Meds for clients that relapse?
Naltrexone(Revia
disulfram(antabuse)
acamprostate(Campral)
Treatment approaches for client with substance use d/o?
1.confrontation
2.referral and self help grps
3.life style changes:cope mec
4.intervention
5.educate
co-occurring d/o?
mental illness and substance abuse d/o
who is higher risk for substance abuse?
mentally ill (Axis 1)

antisocial/borderline(axis 2)
Treatment for client with dual dx?
antidepressants(ssris)
2nd generation antipsychotics
with dual dx what anti anxiety meds is preffered?
Buspar, klonopin
co-existing problems seen in the E.D?
1.drunk-suicidal
2.chronic cocaine use-suicide attemt/M.I or CVA
3.Cocaine crash:severe depression
4.stimulants:hallucinations
Assessment of client with substance use d/o?
be non judgmental
ask open ended questions
look for denial in pt
appearances:v/s neuro,toxic screen
What substance should not be used with prescribed meds?
stimulant:speed,cocaine
depressants
marijuana/hallucinogenics
tobacco
treatment model
1.sequential?
2.parallel?
3.intergraded?
Most accepted principle?
1.most severe d/o tx 1st
2.tx d/o simultaneosly
3.one program provides both
abstinence
Nursing care must take into account:
-socialization
-relapse prevention
-suicide precaution