Psych Review Sheet
Eating Disorders
o More common in women.
o Anorexia has high mortality rate.
o May have mixture of the disorders.
o Comorbid psych issues with anorexia and bulimia, often linked to sexual abuse.
o Tends to run in families.
o Clients who abuse laxatives are at greatest risks for complications.
Î Pica: persistent ingestion of nonfood substances.
Î Rumination: repeated regurgitation of food that is then rechewed, re-swallowed or spit out.
Î Anorexia Nervosa
Nervosa:
Restricting Type: dieting, fasting, excessive exercise.
Binging: binging and purging (vomiting, laxatives, enemas and diuretics. Not all binge eat when they
purge.
o Onset between age 14-18 years old.
o Ignore their hunger.
o Strives for perfection.
o Guilt, anger and emptiness. Denial early on, depression and lability and isolation with
progression.
o Intense fear of gaining weight or becoming fat.
o Disturbed body shape or size (diets although not overweight).
o Inability or refusal to acknowledge that there is a problem making treatment difficult.
o Dieting at young age.
o Might wear large baggy clothes.
o Less than the minimum expected weight and continues to get thinner.
o Preoccupation with food and food related activities (grocery shopping/cooking/dieting).
o Exercises excessively even when tired or injured.
o Risk factors include:
o Obesity
o Lack of family support
o Parental maltreatment
o Cannot deal with conflict
o Media and cultural idea of being thin
o May experience:
o Amenorrhea o Pedal edema
o 85% below weight o Electrolyte imbalances
o Multi-organ failure o Enlarged parotid
o Decreased bone density gland/hypothermia (<36.1
o Decreased muscle mass C)
o Hypoglycemia o Hair loss
o Hypokalemia o Dry skin
o Arrhythmias o Dental carries
o Constipation o Bradycardia (40 BPM)
o Lanugo (hair on body) o Risk for suicide
o Treatment and Nursing Interventions include:
o Promote weight gain, correct malnutrition and resolve underlying psych issue.
o Sitting with patient while eating and after they eat
, o Monitor weight, weigh in gown daily, turn around on scale. (gain 1lb a week while
refeeding)
o Locked bathroom/ supervised
o Group therapy
o Urge logs/ diaries
o Conservation of energy
o CBT
o Rehydration
o Correct electrolyte imbalances
o Amitriptyline and Cyproheptadine (antihistamines) can promote weight gain in
inpatients. Must be high doses (28mg/day)
o Olanzapine (antipsychotic) fixes bizarre body distortions
o Fluoxetine (antidepressants) prevents relapse but can cause weight loss and
appetite suppression.
Î Bulimia Ner
Nervosa:
vosa:
o Engages in binge eating
o Begins in late adolescence or early adulthood.
o Recurrent episodes of binge eating.
o At least once a week for 3 months.
o More common than anorexia.
o Sometimes picked up by dentist because of decreased enamel.
o Feels like eating is often out of control.
o Uses bathroom frequently after meals
o Engages in exercise, vomiting or laxative abuse.
o Reacts to stress by overeating
o Experiences frequent fluctuations in weight, but usually a normal weight.
o Overvalues weight as basis for self esteem
o Depressive or varying moods.
o Nursing interventions and Treatments:
Journals
Postpone binges through distractions
Avoidance of triggers
Expose client to attractive average weight models
Support groups
Observe patient post eating for 1-2 hours
CBT
Vital signs
M I a O
Lock bathroom
Check for hoarding
HALT binges (hungry angry lonely tired)
D .
Antidepressants
Î Binge Eating
o Eats large amounts of food when not physically hungry.
o Food is a way to cope with feelings.
o Eats rapidly and excessively throughout the day
o Eats to the point of feeling uncomfortably full.
o Often eats alone because of shame or embarrassment.
, o Signs of depression and withdrawal and feels guilty and shameful after eating.
o Loss of control when eating at least once a week for 3 months
o No compensatory behavior follows the binge.
o Frequently affects people over the age of 35.
o More often in men then any other disorder.
o Prevalence in lower socioeconomic groups 6 times greater
o Likely to be overweight or obese (BMI > 30)
o Can reduce obesity by:
Increase physical activity
Increase fruits and vegetables
Motivational interviewing techniques
Increase breast feeding
Decrease sugary drinks
Decrease consumption of high energy dense foods (high calorie)
Limit TV and video time totals per day.
o Moderation vs. consumption. Prevalence in lower socioeconomic groups 6 times greater
Anxiety and Stress Related Disorders
o Most common of all psychiatric disorders.
o First episode by 21.5 years old
o Symptoms negatively affect persons ability to function in work or interpersonal relationships
o Can be associated with other mental and physical illnesses such as rep, cardiac and mood
disorders.
o Panic attacks also occur.
o Biologic and psychological factors cause anxiety along with personality traits, low self-
esteem, negative family influences, culture or a traumatic/ stressful precipitating event.
Î Panic Disorder
Disorder: 15-30 minutes of rapid, intense escalating anxiety with great emotional fear and
physiologic discomfort.
o Dx: recurrent unexpected attacks followed by at least one month of persistent concern or
worry about the future attacks or a significant behavioral change related to them.
o Sxs include:
Palpitations Fear of having another
Sweating attack
Shaking Decreased attention span
SOB or smothering Selective mutism in children
sensation who choose not to speak in
Chest pain sociable situations even
N/V or abdominal distress though they are able to
Dizziness Avoidance behavior
Derealization or Increased risk of suicide
depersonalization with panic disorder
Feat of going crazy or dying Significant maladaptive
Chills or hot flashes changes to avoid another
Paresthesia attack
o TX:
Move client to a quiet area/ safe environment
Exercise regularly/ balanced diet
Guided imagery/ meditation
Eating Disorders
o More common in women.
o Anorexia has high mortality rate.
o May have mixture of the disorders.
o Comorbid psych issues with anorexia and bulimia, often linked to sexual abuse.
o Tends to run in families.
o Clients who abuse laxatives are at greatest risks for complications.
Î Pica: persistent ingestion of nonfood substances.
Î Rumination: repeated regurgitation of food that is then rechewed, re-swallowed or spit out.
Î Anorexia Nervosa
Nervosa:
Restricting Type: dieting, fasting, excessive exercise.
Binging: binging and purging (vomiting, laxatives, enemas and diuretics. Not all binge eat when they
purge.
o Onset between age 14-18 years old.
o Ignore their hunger.
o Strives for perfection.
o Guilt, anger and emptiness. Denial early on, depression and lability and isolation with
progression.
o Intense fear of gaining weight or becoming fat.
o Disturbed body shape or size (diets although not overweight).
o Inability or refusal to acknowledge that there is a problem making treatment difficult.
o Dieting at young age.
o Might wear large baggy clothes.
o Less than the minimum expected weight and continues to get thinner.
o Preoccupation with food and food related activities (grocery shopping/cooking/dieting).
o Exercises excessively even when tired or injured.
o Risk factors include:
o Obesity
o Lack of family support
o Parental maltreatment
o Cannot deal with conflict
o Media and cultural idea of being thin
o May experience:
o Amenorrhea o Pedal edema
o 85% below weight o Electrolyte imbalances
o Multi-organ failure o Enlarged parotid
o Decreased bone density gland/hypothermia (<36.1
o Decreased muscle mass C)
o Hypoglycemia o Hair loss
o Hypokalemia o Dry skin
o Arrhythmias o Dental carries
o Constipation o Bradycardia (40 BPM)
o Lanugo (hair on body) o Risk for suicide
o Treatment and Nursing Interventions include:
o Promote weight gain, correct malnutrition and resolve underlying psych issue.
o Sitting with patient while eating and after they eat
, o Monitor weight, weigh in gown daily, turn around on scale. (gain 1lb a week while
refeeding)
o Locked bathroom/ supervised
o Group therapy
o Urge logs/ diaries
o Conservation of energy
o CBT
o Rehydration
o Correct electrolyte imbalances
o Amitriptyline and Cyproheptadine (antihistamines) can promote weight gain in
inpatients. Must be high doses (28mg/day)
o Olanzapine (antipsychotic) fixes bizarre body distortions
o Fluoxetine (antidepressants) prevents relapse but can cause weight loss and
appetite suppression.
Î Bulimia Ner
Nervosa:
vosa:
o Engages in binge eating
o Begins in late adolescence or early adulthood.
o Recurrent episodes of binge eating.
o At least once a week for 3 months.
o More common than anorexia.
o Sometimes picked up by dentist because of decreased enamel.
o Feels like eating is often out of control.
o Uses bathroom frequently after meals
o Engages in exercise, vomiting or laxative abuse.
o Reacts to stress by overeating
o Experiences frequent fluctuations in weight, but usually a normal weight.
o Overvalues weight as basis for self esteem
o Depressive or varying moods.
o Nursing interventions and Treatments:
Journals
Postpone binges through distractions
Avoidance of triggers
Expose client to attractive average weight models
Support groups
Observe patient post eating for 1-2 hours
CBT
Vital signs
M I a O
Lock bathroom
Check for hoarding
HALT binges (hungry angry lonely tired)
D .
Antidepressants
Î Binge Eating
o Eats large amounts of food when not physically hungry.
o Food is a way to cope with feelings.
o Eats rapidly and excessively throughout the day
o Eats to the point of feeling uncomfortably full.
o Often eats alone because of shame or embarrassment.
, o Signs of depression and withdrawal and feels guilty and shameful after eating.
o Loss of control when eating at least once a week for 3 months
o No compensatory behavior follows the binge.
o Frequently affects people over the age of 35.
o More often in men then any other disorder.
o Prevalence in lower socioeconomic groups 6 times greater
o Likely to be overweight or obese (BMI > 30)
o Can reduce obesity by:
Increase physical activity
Increase fruits and vegetables
Motivational interviewing techniques
Increase breast feeding
Decrease sugary drinks
Decrease consumption of high energy dense foods (high calorie)
Limit TV and video time totals per day.
o Moderation vs. consumption. Prevalence in lower socioeconomic groups 6 times greater
Anxiety and Stress Related Disorders
o Most common of all psychiatric disorders.
o First episode by 21.5 years old
o Symptoms negatively affect persons ability to function in work or interpersonal relationships
o Can be associated with other mental and physical illnesses such as rep, cardiac and mood
disorders.
o Panic attacks also occur.
o Biologic and psychological factors cause anxiety along with personality traits, low self-
esteem, negative family influences, culture or a traumatic/ stressful precipitating event.
Î Panic Disorder
Disorder: 15-30 minutes of rapid, intense escalating anxiety with great emotional fear and
physiologic discomfort.
o Dx: recurrent unexpected attacks followed by at least one month of persistent concern or
worry about the future attacks or a significant behavioral change related to them.
o Sxs include:
Palpitations Fear of having another
Sweating attack
Shaking Decreased attention span
SOB or smothering Selective mutism in children
sensation who choose not to speak in
Chest pain sociable situations even
N/V or abdominal distress though they are able to
Dizziness Avoidance behavior
Derealization or Increased risk of suicide
depersonalization with panic disorder
Feat of going crazy or dying Significant maladaptive
Chills or hot flashes changes to avoid another
Paresthesia attack
o TX:
Move client to a quiet area/ safe environment
Exercise regularly/ balanced diet
Guided imagery/ meditation
