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97 Cards in this Set
- Front
- Back
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CHAPTER EIGHTEEN
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(Ignore this card)
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clients with anorexia nervosa have a body weight that is what % of expected normal weight?
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85%
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Describe Anorexia Nervosa, Restricting type
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the individual drastically restricts food intake and does not binge or purge
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Describe Anorexia Nervosa, Binge-eating/Purging Type
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the individual engages in binge eating or purging behaviors
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The average age of onset in females for bulimia nervosa is
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15-18
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What percent of clients with bulimia nervos are males?
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10-15%
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Onset age of bulimia nervosa in males is
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18-26
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Describe the most common type of bulimia nervosa in males
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bingeing with the use of excessive exercise (nonpurging type)
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Nonpurging type of Bulimia Nervosa - describe
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the client may compensate for bingeing thorugh means other than purging - uses excessive exercise, laxatives, diuretics, and/or enemas
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Are mortality rates for eating disorders low or high?
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High
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Which neurotransmitter may be implicated in eating disorders
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disturbances of the serotonin pathways
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What childhood trait may be implicated in eating disorders?
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Hx of being a picky eater
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Catastrophizing
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Ex: "my life is over if I gain weight"
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Personalization
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Ex: "when I walk through the hospital hallway, I know everyone is looking at me"
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Emotional reasoning
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Ex: "I know I look bad because I feel bloated"
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What can happen to VS in eating disorders?
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Low B/P with possible orthostatic hypotension; decreased pulse and body temperature
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Describe the skin, hair, and nails of clients with anorexia
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may have fine, downy hair (lanugo) on the face and bacck; yellowed skin; mottled, cool extremities; poor skin turgor
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What happens to the parotid glands with eating disorders
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enlargement
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What happens to the cardiovascular system with eating disorders
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irregular heart rate, heart failure, cardiomyopathy
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Do clients with eating disorders have edema?
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They may have peripheral edema
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Is muscle weakness an effect of eating disorders?
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Yes
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Describe GI symptoms in patients with eating disorders
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constipation, self-induced vomiting, excessive use of diurectics or laxatives
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Anorexia may be accompanied by amenorrhea for how long?
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at least 3 consecutive cycles
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The patient with an eating disorder may be admitted to the hospital if they have rapid weight loss or gain of greater than __ % of body weight over how long?
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30% over 6 months
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What elyte problem may appear in clients with bulimia
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hypokalemia due to vomiting
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Dehydration stimulates production of what?
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aldosterone
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Aldosterone is responsible for
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water and Na retention and K excretion
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What happens to the blood of clients with anorexia
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anema, leukopenia, lymphocytosis
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Will clients with anorexia have a normal thyroid function test?
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No
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What happens to the carotene levels in clients with anorexia? What physical sign does this appear as?
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elevated carotene levels, which causes skin to yellow
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How much caffeine should clients with eating disorders have?
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none
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Describe the meals which should be given to clients with eating disorders
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small, frequent, high in fiber, low in Na (to control fluid retention), low in high-fat or gassy foods at the start
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Refeeding syndrome
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the circulatory collapse that occurs when a client's completely compromised cardiac system is overwhelmed by a replenished vascular system after normal fluid intake resumes
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In order to avoid refeeding syndrome, refeeding should be implemented over
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7 days
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Cardiac dysrhythmias, severe bradycardia, and hypotension are a possible complication of eating disorders
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(Please ignore this side of the card)
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CHAPTER TWENTY-FIVE
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(Ignore this card)
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Necessary loss
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A loss that is part of the cycle of life, anticipated but may still be intensely felt
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Describe Worden's four tasks of mourning
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(1) accepting the inevitability of the loss; (2) using coping mechanisms to experience the emotional pain of the loss; (3) changing the environment to accommodate the absence of the deceased; (4) readjusting emotional ties to new individuals, and moving thoughts about the deceased to a less prominent place in everyday thoughts
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How long do Worden's four tasks of mourning typically take?
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1 year
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In normal grief, some acceptance should be evident by when?
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6 months
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Do somatic complaints occur with normal grief?
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Yes: chest pain, palpitations, HA, nausea, changes in sleep patterns, fatigue
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Disenfranchised grief
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grief that entails an experienced loss that cannot be publicly shared or is not socially acceptable, such as the loss of a loved one through suicide
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Palliative care is used when the client is not expected to live longer than
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6 months
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The law may require an autopsy to be performed if the death is
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due to homicide, an accident, or occurs within 24 hours of hospital admission
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CHAPTER TWENTY-SIX
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(Ignore this card)
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Children with PTSD will respond to the precipitating event in a series of phases. Describe the phases
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Begin with an arousal that lastas a few minutes to hours followed by a peirod of about 2 weeks in which the child will attempt to deal with the event using defense mechanisms. The last phase, lasting for a period of several months, is when the hcild may have psychologic symptoms as attempts are made to cope with event. Failure to cope can lead to obsession regarding the event
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Behaviors associated with ADHD mst be present
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prior to age 7 and must be present in more than one setting
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What are the types of ADHD
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combined type (most common), ADHD predominantly inattentive, ADHD predominantly hyperactive-impulsive
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Autism
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complex neurodevelopmental disorder believed to be of genetic origin with a wide spectrum of behaviors affecting an individual's ability to communicate and interact with others; cognitive and language development are typically delayed. Characteristic behaviors include inability to maintain eye contact, repetitive actions, and strict observance of routines
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Autism is usually observed before
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3 years of age
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Physical difficulties experienced by the child with autism include
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sensory integration dysfunction, sleep disorders, digestive disorders, feeding disorders, epilepsy, and/or allergies
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Mental retardation is described as
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IQ < 70
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CHAPTER TWENTY-SEVEN
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(Ignore this card)
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Crisis
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an acute, time-limited (usually lasting 4-6 weeks) event during which a client experiences an emotional response that cannot be managed with the client's normal coping mechanisms
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Situational/external crisis
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often unanticipated loss or change experienced in every day, often unanticipated, life events
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Maturational/internal crisis
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achieving new developmental stages, which requires learning additional coping mechanism
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Adventitious crisis
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the occurrence of natural disasters, crimes, or national disasters
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Four phases of a crisis
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(1) escalating anxiety from a threat activates increased defense responses; (2) anxiety continues escalating as defense responses fail, functioning becomes disorganized, and the client resorts to trial-and-error attempts to resolve anxiety; (3) trial-and-error methods of resolution fail, and the client's anxiety escalates to severe or panic levels, leading to flight or withdrawal behaviors; (4) the client experiences overwhelming anxiety that can lead to anguish and apprehension, feelings of powerlessness and being overwhelmed, dissociative symptoms (depersonalization, derealization), depression, confusion, and/or violence against others or self
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CHAPTER TWENTY-EIGHT
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(Ignore this card)
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Describe an overt suicidal comment
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client directly gives evidence of suicidal thinking
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Describe a covert suicidal comment
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client indirectly gives evidence of suicidal thinking
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The suicidal client should only use what sort of eating utensils
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plastic
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Is a no-suicide contract legally binding?
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no
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No-suicide contracts are discouraged for clients who are
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in crisis, under the influence of substances, psychotic, very impulsive, and/or very angry/agitated.
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CHAPTER TWENTY-NINE
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(Ignore this card)
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Anger becomes negative when it is
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denied, suppressed, or expressed inappropriately
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Denied or suppressed anger can manifest as
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physical or psychological symptoms, such as HA, CAD, HTN, gastric ulcers, depression, or low self-esteem
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Describe the three categories of aggression
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(1) preassaultive - the client begins to become angry and exhibits increasing anxiety, hyperactivity, and verbal abuse; (2) assaultive - the client commits an act of violence; (3) postassaultive - staff reviews the incident with the client during this stage
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How much personal space should be given to the assaultive client?
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as much as possible
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Should the nurse maintain eye contact with the assaultive client?
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Yes, maintain eye contact and sit or stand at the same level as the client
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How many staff should be available for a 'show of force' with an assaultive client
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four to six
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What medication is given to the assaultive client?
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Haloperidol (Haldol)
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What sort of medication is Haldol?
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conventional antipsychotic
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When administering Haldol, what S/S should be watched for?
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parkinsonism and anticholinergic side effects
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CHAPTER THIRTY
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(Ignore this card)
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Is a person with mental illness more likely to harm a stranger than a person without mental illness?
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No
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What is the factor most likely to cause violence between strangers?
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a past history of violence and criminal activity
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Victims of family violence are at the greatest risk when they
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try to leave the relationship
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Does pregnancy tend to increase or decrease the risk of violence from a partner?
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Increased risk
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The child who is under ____ is at increased risk of family violence
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3
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Describe the three phases of violence between domestic (intimate) partners
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(1) tension-building phase - the abuser has minor episodes of anger and may be verbally abusive and responsible for some minor physical violence; the victim is tense during this stage and tends to acccept the blame for what is happening; (2) serious battering phase - the tension becomes too much to bear and a serious incident takes place. The victim may try to cover up the injury or may get help; (3) honeymoon phase - the situation is defused for awhile after the violence episode; the abuser becomes loving, promises to change, and is sorry for the behavior; the civtim wants to believe this and hopes for a change. Eventually, the cycle begins again.
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Shaking a baby may cause
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intracranial hemorrhage, retinal hemorrhage
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Assess the shaken baby for
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respiratory depresion, bulging fontanelles, and increased head circumference
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Any bruising on an infant before age _______ is suspicious
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6 months
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Critical incident stress debriefing
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a crisis intervention strategy used to assist individuals who have experienced a traumatic event, usually involving violence, in a safe environment
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CHAPTER THIRTY-ONE
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(Ignore this card)
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Drugs used for rape include
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Flunitrazepam (Rohypnol) and scopolamine (Burundanga)
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How long does the acute phase of rape-trauma syndrome last?
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2 weeks
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In rape-trauma syndrome, an expressed reaction is
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overt; consists of emotional outbursts, including crying, laughing, hysteria, anger, and incoherence
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In rape-trauma syndrome, a controlled reaction is
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ambiguous; survivor may appear calm and have blunted affect, but may also be confused, have difficulty making decisions, and feel numb
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A somatic reaction to rape occurs later and lasts about
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2 weeks
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The somatic complaints related to rape-trauma syndrome include
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brusing and soreness from the attack, muscle tension, HA, sleep disturbances, GI symptoms, GU symptoms, and emotional reactions
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The long-term reorganization phase of rape-trauma syndrome occurs
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2 weeks or more after the attack
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The compound reaction to rape-trauma syndrome is characterized by
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reliance on ETOH or other durgs, and reactivated symptoms of previous conditions, such as physical or psychiatric illness
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The silent reaction to rape-trauma syndrome is characterized by
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abrupt changes in relationships with partners, nightmares, increased anxiety during interview, marked changes in sexual behavior, sudden onset of phobic reactions, and no verbalization of the occurrence of the rape
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SANE
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sexual assault nurse examiner
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What medication should be given to the patient who has just experienced rape?
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prophylactic treatment for STIs
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