NURSE-UN 241 Study Guide - Final Guide: Boxed Warning, Bulimia Nervosa, Impulse Control Disorder
27 Nov 2018
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Serum: high cholesterol, hepatic enzymes, low positive e+ Body image influence self-evaluation recurrent binge eating. Priority: restore nutrition: bmi<17, lanugo, hypothermia, ecg changes, depression suicide assessment, refeeding syndrome, hypophosphatemia>hypocalcemia (insulin, rhabdomyolysis- muscle wasting. Bun/creat ration decreased: these e+ are trapped intracellularly and the serum level look normal. Factors: opioid denial of hunger, serotonin, dopamine, ne, family over controlling and perfectionistic, fluoxetine (prozac) weight gain, ssri black box warning! Factors: serotonin and ne, endorphin levels after vomiting. Priority: nutritional state, e+ imbalance: hypokalemic alkalosis or acidosis + cramps/ tetany, rf. Suicidal ideation: anxiety, obsessive-compulsive, related disorders. Out of proportion: intensity and duration, response, coping. Increase in ne, cortisol, crh; decrease in serotonin, gaba. Pharm: alprazolam (xanax) - benzo, paroxetine (paxil) - ssri, all ssris are good, benzo until ssri is effective. Pharm: ssri, paroxetine, escitalopram, snri: venlafaxine, duloxetine, benzo, alprazolam (xanax, lorazepam (ativan, clonazepam (klonipin, buspirone (buspar)
