NUR 256 Mental Health Exam 4 Study Guide | Actual
verified study complete Solutions | A+ Graded |
2026 Updates | 100% correct
Describe Clinical Manifestations (what do they look like, their vitals, what
comment will they make, their labs), interventions, and Therapies. Labs to focus
on for eating disorders: ECG, albumin, all electrolyte (potassium, sodium). Know
Personality traits for eating disorder
1. Anorexia Nervosa (Pg. 335)
• They are very obsessive; they feel like they have to be a certain way which is
their perception of how they should be when no one else is asking. This is
influenced by environmental factors, stress, Their Characteristics:
• Intense fear of weight gain, distorted body image, restricted calories with
significantly low BMI
• Subtypes: restricting (no consistent bulimic features), binge/eating/purging
type (primarily restriction, some bulimic behaviors)
• They don’t think they have a problem, they fail to keep a good BMI
Clinical Presentation:
• Low weight due to caloric restriction and excessive exercise
• Lanugo. And cold extremities due to starvation
• Abnormal labs due to starvation (low triiodothyronine, low thyroxine levels)
• Cardiovascular abnormalities due to electrolyte imbalance and dehydration
(hypotension, bradycardia, heart failure) ***
Hypokalemia (<3.5) due to starvation
Intervention
• Acute Care: patient will be admitted into a facility when they are in crisis
,
• Suicidal ideation: determine if this is present before anything else, while
doing this you will need to build trust with the patient before you can move
forward with treatment Treatment:
• Psychosocial:. Begin re-feeding process, introduce patient into the milieu to
group therapy and determine underlying cause of eating disorder. There are
no meds, but once patient has reached 75% of their ideal body weight (BMI
20-25) that is when the nurse can consider giving them an SSRI to help
manage their symptoms of OCD. Usually it is Fluoxetine (Prozac) as it is very
effective tor treating OCD (high dose would be given)
• The goal of therapy is to teach them how to look at food as a healthy thing
and it is there to sustain life, and that it is a requirement for healthy leaving.
2. Bulimia Nervosa Pg. 335
• They look healthy, but really they are binging and purging. They may ask for
help. The reason they purge is because they have a euphoric feeling after
that so they binge and then they make themselves vomit Their
Characteristics:
• Recurrent episode of uncontrollable binging
• Inappropriate compensatory behaviors: vomiting, laxatives, diuretics, or
exercise
• Self-image largely influenced by body image
Physical sign
• They have a lot of dental problems from all of the gastric acid, they have
issues with GERD, they have a lot of GI issues which is all due to the acid
from vomiting
• Electrolyte imbalance
• Inability to maintain stable relationship, so we must watch them socially,
are they avoiding people
• They also have that Obsessive compulsive feeling to them not so much like
that perfectionism as anorexia Treatment:
Amphetamine like drug, SSRI, TCA, Topiramate (Topamax), to suppress and
help managed the need to eat so much that they make themselves throw
up.
,
• Cognitive behavior therapy, a lot of time these patient will get dose at a
higher dose compare to someone been treated for depression which is out
of the safe zone. Chances that we are treating the bulimia because we want
to suppress their need to vomit their food
Intervention
• No access to laxatives, diuretics, or anything that will help them to get rid
of intake, no trip to bathroom
• We must keep them on a scheduled routine
• Once we stabilized them and they are taking their medication; we want to
talk to them about grocery shopping skills.
• Stabilization include : what are you eating, when are you eating, are you
keeping your food down
3. Binge eating Pg. 335
• Do not mistake this for Obesity.
• The term Binge eating means: eating large amount, eat multiple times
throughout the day, eating in secrets
• The do this when they are stress, bored
• They eat because it is an emotional response, not because they are
hungry
• Remember they are not binging and purging, they are only binging they
are eating a lot of food multiple time which is as dangerous as obesity.
Their Characteristics:
• Recurrent episodes of uncontrollable binging without compensatory
behaviors
• Binging episodes induce guilt, depression, embarrassment, or disgust
Intervention
• Look at what is going (Psychosocially, emotionally, environmental stress) on
causing the patient to binge large amount of foods
• We need to address the facts, Ask client: We notice you have a high BMI,
tell me about your diet, do you snack at night, do you snack when you
stress
Ask questions to determine if the patient is using food as way to not deal
with their issues.
verified study complete Solutions | A+ Graded |
2026 Updates | 100% correct
Describe Clinical Manifestations (what do they look like, their vitals, what
comment will they make, their labs), interventions, and Therapies. Labs to focus
on for eating disorders: ECG, albumin, all electrolyte (potassium, sodium). Know
Personality traits for eating disorder
1. Anorexia Nervosa (Pg. 335)
• They are very obsessive; they feel like they have to be a certain way which is
their perception of how they should be when no one else is asking. This is
influenced by environmental factors, stress, Their Characteristics:
• Intense fear of weight gain, distorted body image, restricted calories with
significantly low BMI
• Subtypes: restricting (no consistent bulimic features), binge/eating/purging
type (primarily restriction, some bulimic behaviors)
• They don’t think they have a problem, they fail to keep a good BMI
Clinical Presentation:
• Low weight due to caloric restriction and excessive exercise
• Lanugo. And cold extremities due to starvation
• Abnormal labs due to starvation (low triiodothyronine, low thyroxine levels)
• Cardiovascular abnormalities due to electrolyte imbalance and dehydration
(hypotension, bradycardia, heart failure) ***
Hypokalemia (<3.5) due to starvation
Intervention
• Acute Care: patient will be admitted into a facility when they are in crisis
,
• Suicidal ideation: determine if this is present before anything else, while
doing this you will need to build trust with the patient before you can move
forward with treatment Treatment:
• Psychosocial:. Begin re-feeding process, introduce patient into the milieu to
group therapy and determine underlying cause of eating disorder. There are
no meds, but once patient has reached 75% of their ideal body weight (BMI
20-25) that is when the nurse can consider giving them an SSRI to help
manage their symptoms of OCD. Usually it is Fluoxetine (Prozac) as it is very
effective tor treating OCD (high dose would be given)
• The goal of therapy is to teach them how to look at food as a healthy thing
and it is there to sustain life, and that it is a requirement for healthy leaving.
2. Bulimia Nervosa Pg. 335
• They look healthy, but really they are binging and purging. They may ask for
help. The reason they purge is because they have a euphoric feeling after
that so they binge and then they make themselves vomit Their
Characteristics:
• Recurrent episode of uncontrollable binging
• Inappropriate compensatory behaviors: vomiting, laxatives, diuretics, or
exercise
• Self-image largely influenced by body image
Physical sign
• They have a lot of dental problems from all of the gastric acid, they have
issues with GERD, they have a lot of GI issues which is all due to the acid
from vomiting
• Electrolyte imbalance
• Inability to maintain stable relationship, so we must watch them socially,
are they avoiding people
• They also have that Obsessive compulsive feeling to them not so much like
that perfectionism as anorexia Treatment:
Amphetamine like drug, SSRI, TCA, Topiramate (Topamax), to suppress and
help managed the need to eat so much that they make themselves throw
up.
,
• Cognitive behavior therapy, a lot of time these patient will get dose at a
higher dose compare to someone been treated for depression which is out
of the safe zone. Chances that we are treating the bulimia because we want
to suppress their need to vomit their food
Intervention
• No access to laxatives, diuretics, or anything that will help them to get rid
of intake, no trip to bathroom
• We must keep them on a scheduled routine
• Once we stabilized them and they are taking their medication; we want to
talk to them about grocery shopping skills.
• Stabilization include : what are you eating, when are you eating, are you
keeping your food down
3. Binge eating Pg. 335
• Do not mistake this for Obesity.
• The term Binge eating means: eating large amount, eat multiple times
throughout the day, eating in secrets
• The do this when they are stress, bored
• They eat because it is an emotional response, not because they are
hungry
• Remember they are not binging and purging, they are only binging they
are eating a lot of food multiple time which is as dangerous as obesity.
Their Characteristics:
• Recurrent episodes of uncontrollable binging without compensatory
behaviors
• Binging episodes induce guilt, depression, embarrassment, or disgust
Intervention
• Look at what is going (Psychosocially, emotionally, environmental stress) on
causing the patient to binge large amount of foods
• We need to address the facts, Ask client: We notice you have a high BMI,
tell me about your diet, do you snack at night, do you snack when you
stress
Ask questions to determine if the patient is using food as way to not deal
with their issues.
