Psych NUR 162 > Test 4 (Mods) > Flashcards

Test 4 (Mods) Flashcards

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1
Q

What is the simplest way to view the following eating disorders?
Anorexia:
Bulimia:
Obesity:

A

Anorexia: too little
Bulimia: to chaotically (excessive amount of food taken in over 2 hours)
Obesity/Binge Eating Disorder: too much

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2
Q

What are some physical problems of anorexia nervosa?

A

Amenorrhea, Constipation, Overly sensitive to cold (lanugo hair on body), Loss of body fat, Muscle atrophy, Hair loss, Dry skin, Dental caries, Pedal edema, Bradycardia/arrhythmia, Orthostasis, Enlarged parotid glands/hypothermia, & Electrolyte imbalance

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3
Q

What are some key characteristics of binge eating disorders?

A

Recurrent episodes of binge eating [consuming a large amount of food in a discrete period (e.g., within 2 hours) with a sense of lack of control.]
No regular use of inappropriate compensatory behaviors
Affects people over 35 & more likely men

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4
Q

What is night eating syndrome?

A

Morning anorexia and eats 50% of daily calories after the last evening meal and nighttime awakenings

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5
Q

What is PICA?

A

Nonfood substances are ingested

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6
Q

What is rumination?

A

Repeated regurgitation of food that is rechewed, reswallowed, or spit out.

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7
Q

What is orthorexia?

A

Obsessed with eating healthy-Not in the DSM-5 yet

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8
Q

What kind of family dynamic usually results in a person having an eating disorder?

A

Overprotective or enmeshed (no clear boundaries)

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9
Q

T/F: One current biologic theory about eating disorders is that it involves a disruption in the cerebellum portion of the brain .

A

False
Rationale: One of the biologic theories of eating disorders involves disruption of the nuclei in the hypothalamus that relate to hunger and satiety.

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10
Q

When is the usual onset age of anorexia nervosa?

A

14 and 18

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11
Q

How is anorexia nervosa treated?

A

Has to be treated in a specialized facility
- So may need to be hospitalized before going for psychological help d/t a deficiency
The highest death rate of all psychiatric disorders

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12
Q

How might an anorexia nervosa patient present emotionally?

A

Stoic
Decreased sense of humor
Rude
Poor insight
Fear & Mistrust
Have a hard time distinguishing feelings

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13
Q

What is the goal of anorexia nervosa tx?

A

restoration of weight and imbalance

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14
Q

What type of psychopharmacology treatments are used to treat anorexia nervosa?

A

Amitriptyline(Elavil) and cyproheptadine(Periactin) - causes weight gain
Olanzapine(Zyprexia) - causes weight gain
Fluoxetine(Prozac) (long half-life) - causes weight lost – given after pt. has gained weight to increase serotonin

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15
Q

What are some developmental & family risk factors of anorexia nervosa?

A

Developmental Risk Factors -Issues of developing autonomy and having control over self and environment, dissatisfaction with body image

Family Risk Factors -Lack of emotional support, parental maltreatment, cannot deal with conflict

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16
Q

When is the onset of of bulimia nervosa?

A

Late adolescence, early adulthood (average 18-19)

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17
Q

What are the traditional treatments of bulimia nervosa?

A

Cognitive–behavioral therapy
Psychopharmacology: antidepressants

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18
Q

How do patients with bulimia nervosa typically present physically? How are they emotionally?

A

Usually normal weight

Recognition of behavior as pathologic; feelings of guilt, shame, remorse, contempt

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19
Q

What are some developmental & family risk factors of bulimia nervosa?

A

Developmental Risk Factors-Self-perceptions of being overweight, fat, unattractive, and undesirable, dissatisfaction with body image

Family Risk Factors-Chaotic family with loose boundaries, parental maltreatment, including possible physical or sexual abuse

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20
Q

What is psychosomatic?

A

Connection between mind (psyche) and body (soma)

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21
Q

What is hysteria?

A

Multiple physical complaints with no organic basis

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22
Q

What is somatization?

A

The transference of a mental experiences Into body symptoms

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23
Q

What are the 3 central features of somatic symptom illnesses?

A

Physical symptoms/complaints suggest major medical illness but have no demonstrable organic basis.
Psychological factors/conflicts seem important in initiating/exacerbating/maintaining the symptoms.
Symptoms or magnified health concerns are not under the client’s conscious control.

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24
Q

What are functional neurological symptoms (aka Conversion disorder)?

A

Sudden sensory or motor deficits with no organic basis
E.g., blindness, paralysis

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25
What does La belle indifference mean?
French for "beautiful indifference" Seeming lack of concern or distress about the functional loss
26
Somatic symptoms illnesses- Pain disorder
Pain is the primary physician symptoms Generally unrelieved by analgesics Greatly affects by psychological factors w/ regards to onset, severity, exacerbation
27
Somatic symptoms illnesses- Illness anxiety disorder (formerly hypochondriasis)
Preoccupation with fear that one has a serious disease (disease conviction) or will get a serious disease (disease phobia) - Thought that clients misinterpret bodily sensations
28
Somatic symptoms illnesses onset? Conversion? Illness anxiety?
Symptoms often experienced in adolescence or early adulthood Conversion-10 -35 years Illness anxiety-any age
29
What is Malingering?
The intentional production of false or grossly exaggerated physical or psychological symptoms; motivated by external incentives
30
What is factitious disorder? What was it previously known as?
A person intentionally produces or feigns physical or psychological symptoms solely to gain attention Also known as Munchausen syndrome
31
What is factitious disorder imposed on others? What is it also known as?
Occurs when a person inflicts illness or injury on someone else to gain the attention of emergency medical personnel or to be a “hero” for saving the victim Also known as Munchausen’s by proxy
32
How are malingering and factitious disorders different from somatic symptom illnesses?
Malingering and factitious disorders: willful control of symptoms Somatic symptom illnesses: no voluntary control over symptoms
33
What are the primary gains of somatic symptom illnesses?
Direct internal benefits of being sick- provides relief of anxiety, conflict, or distress
34
What are the secondary gains of somatic symptom illnesses?
External or personal benefits from others because one is sick –attention and comfort measures
35
Men in India often have dhat, what is it?
A hypochondriacal concern about loss of semen
36
What is koro?
Belief that genitals are retracting. Occurs in Southeast Asia and may be related to body dysmorphic disorder
37
What falling-out episodes, and where is it found?
Characterized by a sudden collapse. found in the southern United States and the Caribbean islands.
38
What is hwa-byung?
A Korean folk syndrome, attributed to the suppression of anger and includes insomnia, fatigue, panic, indigestion, and generalized aches and pains
39
Where does Shenjing shuariuo occur?
Occurs in China and includes multiple symptoms (fatigue and various physical complaints)
40
What is Sangue dormido?
Sleeping blood involving numbness/paralysis, particularly in Portuguese-speaking communities.
41
How are somatic symptom illnesses treated?
Symptom management, improving quality of life, and improving coping skills Antidepressants for accompanying depression: selective serotonin reuptake inhibitors Referral to a chronic pain clinic Involvement in therapy groups to improve coping and express emotions Education
42
What are some Emotion-focused coping strategies?
Progressive relaxation, deep breathing, guided imagery, and distractions
43
What are some problem-focused coping strategies?
Learning problem-solving methods, applying the process to identified problems, and role-playing interactions with others
44
Which approach is an example of a problem-focused coping strategy? A. Progressive relaxation B. Deep breathing C. Interaction role-playing D. Guided imagery
Interaction role-playing Rationale: Interaction role-playing is an example of a problem-focused coping strategy. Progressive relaxation, deep breathing, and guided imagery are emotion-focused coping strategies.
45
For Delirium, what is the onset? Duration? LOC? Memory? Speech? Thought processes? Perception? Mood?
Onset: Rapid Duration: Brief (hours to days) LOC: Impaired, fluctuates Memory: Short-term memory impaired Speech: May be slurred, rambling, pressured, irrelevant Thought processes: Temporarily disorganized Perception: Visual or tactile hallucinations, delusions Mood: Anxious, fearful if hallucinating; weeping, irritable
46
For Dementia, what is the onset? Duration? LOC? Memory? Speech? Thought processes? Perception? Mood?
Onset: Gradual and insidious Duration: Progressive deterioration LOC: Not affected Memory: Short- and then long-term impaired, eventually destroyed Speech: Normal in early stage, progressive aphasia in later stage Thought processes: Impaired thinking, eventual loss of thinking abilities Perception: Often absent, but can have paranoia, hallucinations, illusions Mood: Depressed and anxious in early stage, labile mood, restless pacing, angry outbursts in later stages
47
What is remote memory?
The ability to recall events from the distant past
48
What is cognition?
Brain’s ability to process, retain, and use information
49
What are some cognitive abilities?
Reasoning, judgment, perception, attention, comprehension, and memory
50
What is the definition of cognitive disorders? Categories?
Disruption or impairment of the person’s ability to make decisions, solve problems, interpret the environment, and learn new information Categories: delirium, dementia, amnestic disorders
51
What are some Neurocognitve disorders (NCDs)?
Delirium, major NCD, mild NCD, subtypes; dementia
52
What is delirium?
A syndrome involving disturbance of consciousness with change in cognition Usually develops over short period
53
What are some risk factors for delirium?
Hospitalization for general medical conditions Older acutely ill clients Severe physical illness Older age Baseline cognitive impairment (dementia)
54
Etiology of delirium includes:
Usually results from an identifiable physiologic, Metabolic disorder Cerebral disturbance or disease Drug intoxication or withdrawal Drugs Causing Delirium
55
What is the treatment for delirium?
Treatment of the underlying medical condition clears delirium Delirious clients who are quiet and resting need no other medication for delirium
56
What is given to sedate delirious clients to prevent inadvertent self-injury?
Antipsychotics: like haloperidol (Haldol) 0.5 to 1 mg to decrease agitation and psychotics symptoms (may facilitate sleep) Sedatives & benzodiazepines: may worsen delirium (exception is delirium induced by alcohol withdrawal)
57
Dementia involves multiple cognitive deficits, primarily memory impairment, and at least one of the following (4 A's of dementia)?
Aphasia Apraxia Agnosia A disturbance in executive functioning
58
What is aphasia?
Deterioration of language function
59
What is apraxia?
Impaired motor function
60
What is agnosia?
Inability to recognize name of objects
61
What is executive functioning?
Inability to think abstractly
62
Describe the mild stage of dementia
Forgetfulness may have difficulty finding words. Frequently loses objects, begins to have anxiety about these loses Less enjoyment in job/social settings and may avoid Most remain in community
63
Describe the moderate stage of dementia
Confusion is apparent, along w/progressive memory loss Remains OX2 (PP) and still recognizes familiar people Can no longer perform complex tasks Toward end of stage, loses ability to live independently - In community w/ adequate support or other supervised living situations
64
Describe the severe stage of dementia
Personality and emotional changes May be delusional, wander, forget names of family members Require ADL assistance Most live in nursing facilities unless extraordinary community support available
65
What is reminiscence therapy?
Involves the recall of past events, feelings, and thoughts and is often used in dementia care to improve mood, reduce agitation, and enhance communication.
66
What is an important aspect of the treatment of dementia?
Identifying the underlying cause
67
What are some medications for degenerative dementias?
Cholinesterase inhibitors
68
What cholinesterase inhibitors are used to treat dementia, and how do they work?
donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl), they temporarily slow the progress of dementia
69
What is N-Methyl-D Aspartate receptor antagonist-Memantine (Namenda) is used in?
Moderate to severe states of Alzheimer’s
70
What is tacrine (Cognex), and how does it stand out?
A cholinesterase inhibitor that elevates liver enzymes in about 50% of clients
71
A client makes up answers to fill in memory gaps. The nurse identifies this as which condition? A. Echolalia B. Palilalia C. Aphasia D. Confabulation
Confabulation
72
What is Echolalia?
The involuntary, senseless repetition of another person's spoken words or phrases. It's a speech disturbance, often seen in conditions like autism spectrum disorder, schizophrenia, or Tourette's syndrome, but it's not about filling memory gaps.
73
What is Palilalia?
The involuntary repetition of one's own spoken words or phrases. It's also a speech disorder, commonly associated with neurological conditions like Parkinson's disease, but it's not directly related to fabricating memories to cover memory deficits.
74
What is Confabulation?
The act of making up answers or fabricating, distorting, or misinterpreting memories without the conscious intention to deceive, often to fill in gaps in one's memory.
75
What are some of the needs of caregivers of those with dementia?
Education about dementia, required client care Assistance in dealing with own feelings of loss Respite to care for own needs, role strain Support groups Assistance from agencies Support to maintain personal life
76
What amino acid is linked to dementia risk?
Elevated levels of plasma homocysteine
77
What are some measures to decrease risk for Alzheimer’s disease?
Regular participation in brain-stimulating activities Leisure-time physical activity during midlife Large social network
Psych NUR 162
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