{"content":{"sharePage":{"page":0,"digests":[{"id":"20541485","dateCreated":"1266886711","smartDate":"Feb 22, 2010","userCreated":{"username":"BrandiBurns","url":"https:\/\/www.wikispaces.com\/user\/view\/BrandiBurns","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/teamgreennurses.wikispaces.com\/share\/view\/20541485"},"dateDigested":1532288123,"startDate":null,"sharedType":"discussion","title":"Next week for class...","description":"Hey Girls. I bring my psych book with me to class everyday, so it's not a problem for me to bring it next wed :)","replyPages":[{"page":0,"digests":[{"id":"20770215","body":"hey Brandi, yeah, I'll have a back up in my car just in case. I'll bring the Pharm book.<br \/>\n- Rachel","dateCreated":"1267197676","smartDate":"Feb 26, 2010","userCreated":{"username":"trainerrachel00","url":"https:\/\/www.wikispaces.com\/user\/view\/trainerrachel00","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"}}],"more":0}]},{"id":"20541411","dateCreated":"1266886660","smartDate":"Feb 22, 2010","userCreated":{"username":"BrandiBurns","url":"https:\/\/www.wikispaces.com\/user\/view\/BrandiBurns","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"},"monitored":false,"locked":false,"links":{"self":"https:\/\/teamgreennurses.wikispaces.com\/share\/view\/20541411"},"dateDigested":1532288123,"startDate":null,"sharedType":"discussion","title":"My Work","description":"1.    What is the difference between anorexia nervosa, bulimia nervosa and binge eating? Describe the defining characteristics of each disorder.<br \/>\n<br \/>\nAnorexia Nervosa is characterized by preoccupied with food and the rituals for eating, voluntary refusal to eat, endocrine dysfunction and a distorted psychopathic attitude towards weight and eating. Body weight is less than 85% of expected normal body weight. This disease occurs mostly in females. The patient may have a fear of gaining weight and view self as fat even when emaciated. Patients may have a peculiar way of handiling food (pushing it around the plate, cut into tiny pieces), possible rigorous exercise regimen and may judge self worth by weight. Patient may also abuse laxatives as well.<br \/>\n<br \/>\nClinical Manifestations:<br \/>\n-amenorrhea for at least 3 consecutive cycles. <br \/>\n-lanugo<br \/>\n-low weight<br \/>\n-yellow skin<br \/>\n-peripheral edema<br \/>\n-muscle weakening<br \/>\n-abnormal lab values (hypokalemia, anemia, impaired liver and kidney function, abnormal thyroid function tests, elevated carotene levels)<br \/>\n-cardiovascular abnormalities (bradycardia, hypotension)<br \/>\n-continuous diet<br \/>\n-hair loss<br \/>\n-sensitivity to cold<br \/>\n-dry skin<br \/>\n- constipation.<br \/>\n<br \/>\nBulimia Nervosa is characterized by recurrent episodes of eating large quantities of food over a short period of time (binging) that may be followed by inappropriate compensatory behaviors to rid the body of these excessive calories such as purging. Most patients maintain normal weight or may weight slightly higher. There are two types of Bulimia; Binging and Non Purging. The purging type self induce vomiting. They could have erosionor scars on the teeth, fingernails, and knuckles (Russell\u2019s sigs). The non purging type could compensate for bringing through other means, such as excessive exercise and the misuse of laxatives, diuretics and diet drugs of enemas.<br \/>\n<br \/>\nClinical Manifestations:<br \/>\n-normal to slightly high weight<br \/>\n-dental caries, tooth erosion<br \/>\n-parotid swelling<br \/>\n-gastric dilation or rupture<br \/>\n-calluses or scars on hands from self induced vomiting<br \/>\n-peripheral edema<br \/>\n-muscle weakening<br \/>\n-abnormal lab values (electrolytes (hypokalemia ,hyponatremia, hypochloremia,)<br \/>\n-CV abnormalities<br \/>\n-Cardiac failure<br \/>\n-swollen parotid glands<br \/>\n-broken blood vessels in the eyes from vomiting<br \/>\n<br \/>\nBing Eating is associated with obesity. This is when a patient engages in repeated episodes of being eating, after which they experience significant distress. The patient will consume large amounts of food or \u201cover eat\u201d. They usually do not engage in compensatory behaviors like in bulimia<br \/>\n<br \/>\n<br \/>\nClinical Manifestations:<br \/>\n-eating large amounts of food <br \/>\n-eating even when full <br \/>\n-eating rapidly during binge episodes <br \/>\n-feeling that their eating behavior is out of control <br \/>\n-depression <br \/>\n-anxiety <br \/>\n-frequent dieting without weight loss <br \/>\n-frequently eating alone <br \/>\n-hoarding food <br \/>\n-hiding empty food containers <br \/>\n-feeling depressed, disgusted or upset about your eating <br \/>\n<br \/>\n<br \/>\n2. Identify 3 priority nursing diagnoses for the disorders listed in question # 1 above.<br \/>\nAnorexia: Risk for Injury r\/t electrolyte disturbances, muscle weakening and decreased bone density, Decreased cardiac output r\/t starvation, dehydration and electrolyte disturbances, Imbalanced nutrition: less than body requirements r\/t decreased caloric intake and exercise, Disturbed body image<br \/>\nBulimia: Decreased cardiac output r\/t cardiac arrhythmias\/electrolyte disturbances, Ineffective coping r\/t bingeing as manifested by depression and or\/stress, Anxiety<br \/>\nBinge: Imbalanced Nutrition: more than body requirements related to compulsive overeating, Ineffective individual coping r\/t disturbed impulse control related to compulsive overeating, anxiety r\/t <br \/>\n<br \/>\n3. Identify at least 3 nursing interventions specific to the eating disorders.<br \/>\nAnorexia: Monitor food, monitor weight on routine basis, limit physical activity as needed for weight gain<br \/>\nBulimia: Monitor patient for attempts to purge after eating, Retains ingested food, and maintains fluid balance<br \/>\nBinge: Teach exercise maintenance, establish expectations for appropriate eating behaviors, assist patient to evaluate the appropriateness\/consequences of choices about binging.<br \/>\n<br \/>\n4. Identify assessment findings you would expect to find for patients with the following substance abuse issues:<br \/>\n<br \/>\na. Stimulants-increased pulse and blood pressure, weight loss, tremors, dry mouth, decreased saliva, dental decay, elevation of mood, altertness<br \/>\nb. Nicotine-respiratory and CV complications, increased blood pressure and heart rate and increased blood flow, nicotine cravings, <br \/>\n c. Cocaine-\u201cSniffles\u201d or rubbing of nose, dental decay, tachycardia, dilated pupils, elevated BP, possible nausea and vomiting, assaultiveness, grandiosity, impaired judgment, euphoria<br \/>\nd. Alcohol- calmness and relax muscles. Somewhat larger doses can cause slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes.<br \/>\ne. Amphetamines-increased energy, jumpy, dental problems, auditory and tactile hallucinations, anxiety, elevated BP and P<br \/>\nf. Sedative-Hypnotics-constricted pupils, decreased respirations, drowsiness, decreased BP, slurred speech, psychomotor retardation, dysphoria and impairment of attention and judgment.<br \/>\ng. Cannabis-euphoria, relaxations, talkativeness, slowed perception of time, forgetfulness, inappropriate hilarity, heightened sensitivity to external stimuli, anxiety and paranoia.<br \/>\n<br \/>\n5. Write 3 priority nursing diagnoses for each substance listed.<br \/>\nStimulants-Risk for Injury, Impaired Dentition, Risk for Imbalanced Nutrition: less than body requirements<br \/>\nNicotine-Ineffective Coping, Risk for increased cardiac output<br \/>\nCocaine-Risk for injury, Impaired Judgment, Impaired Dentition<br \/>\nAlcohol- Risk for injury, ineffective coping, ineffective health maintenance<br \/>\nAmphetamines-Risk for injury, Impaired social functioning, Anxiety<br \/>\nSedative-Hypnotics-Risk for Injury, Risk for respiratory depression, Impaired Judgment<br \/>\nCannabis-Risk for injury, Anxiety, Risk for Impaired Memory<br \/>\n<br \/>\n<br \/>\n<br \/>\n6. Identify symptoms of withdrawal for the substances listed in #4.<br \/>\na. Stimulants- irritability, headaches, nausea, vomiting, headaches, fatigue, mood swings<br \/>\nb. Nicotine-irritable, rapid mood swings, sweating, tremors, headache, cold symptoms (coughing,) cramps, nausea, sleep disturbances. <br \/>\n c. Cocaine- fatigue, lack of pleasure, anxiety, irritability, sleepiness, and sometimes agitation or extreme suspicion <br \/>\nd. Alcohol- jumpy, nervous, irritable, aggressive, depression, fatigue, anxiety, rapid mood swings<br \/>\ne. Amphetamines-fatigue, depression, agitation, apathy, anxiety, sleepiness, disorientation, lethargy, cravings<br \/>\nf. Sedative-Hypnotics- anxiety, tremors, nightmares, insomnia, poor appetite, rapid pulse, rapid breathing, blood pressure abnormalities, dangerously high fever and seizures <br \/>\ng. Cannabis-irritable, night sweats, drug seeking, anxiety, irritability, depression, headaches, <br \/>\n<br \/>\n<br \/>\n7. Identify priority nursing interventions for patients who use\/abuse the substance listed in # 4.<br \/>\n<br \/>\n-avoid overstimulation<br \/>\n-explain all procedures<br \/>\n-aim treatment towards self responsibility<br \/>\n-allow patient to have choices<br \/>\n-enhance personal insight<br \/>\n-refer to self help community group<br \/>\n-focus on patient strengths<br \/>\n-<br \/>\n<br \/>\n8. Review the material from Case Study #3 (Dementia, etc.)","replyPages":[{"page":0,"digests":[{"id":"20770279","body":"this looks awesome. I put some up on the case study ( main points from lecture) and started working on shizophrenia.<br \/>\n- Rachel","dateCreated":"1267197755","smartDate":"Feb 26, 2010","userCreated":{"username":"trainerrachel00","url":"https:\/\/www.wikispaces.com\/user\/view\/trainerrachel00","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"}},{"id":"20837621","body":"thanks rachel!","dateCreated":"1267394501","smartDate":"Feb 28, 2010","userCreated":{"username":"BrandiBurns","url":"https:\/\/www.wikispaces.com\/user\/view\/BrandiBurns","imageUrl":"https:\/\/ssl.wikicdn.com\/i\/user_none_lg.jpg"}}],"more":0}]}],"more":false},"comments":[]},"http":{"code":200,"status":"OK"},"redirectUrl":null,"javascript":null,"notices":{"warning":[],"error":[],"info":[],"success":[]}}