Podcast
Questions and Answers
What age range does anorexia nervosa typically begin?
What age range does anorexia nervosa typically begin?
In the early stages of anorexia nervosa, what do clients often deny?
In the early stages of anorexia nervosa, what do clients often deny?
What percentage of clients with anorexia achieve full recovery?
What percentage of clients with anorexia achieve full recovery?
What is a common belief among clients with anorexia regarding their peers?
What is a common belief among clients with anorexia regarding their peers?
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What is the likelihood of clients with anorexia to die from medical complications or suicide compared to the general population?
What is the likelihood of clients with anorexia to die from medical complications or suicide compared to the general population?
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What factor tends to lead to the poorest outcomes for clients with anorexia?
What factor tends to lead to the poorest outcomes for clients with anorexia?
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What behavior increases the risk of medical complications for clients with anorexia?
What behavior increases the risk of medical complications for clients with anorexia?
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What becomes more apparent as anorexia nervosa progresses?
What becomes more apparent as anorexia nervosa progresses?
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What percentage of clients with anorexia remain chronically ill?
What percentage of clients with anorexia remain chronically ill?
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What is a common consequence of social isolation for clients with anorexia?
What is a common consequence of social isolation for clients with anorexia?
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What do clients with anorexia often express satisfaction with in the early stages of the illness?
What do clients with anorexia often express satisfaction with in the early stages of the illness?
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What is a common emotional experience for clients with anorexia in the early stages of the illness?
What is a common emotional experience for clients with anorexia in the early stages of the illness?
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Which type of therapy has been even more successful than cognitive-behavioral therapy (CBT) for treating anorexia nervosa?
Which type of therapy has been even more successful than cognitive-behavioral therapy (CBT) for treating anorexia nervosa?
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What is a major life-threatening complication that indicates the need for hospital admission in clients with anorexia nervosa?
What is a major life-threatening complication that indicates the need for hospital admission in clients with anorexia nervosa?
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What is a common complication related to purging (vomiting and laxative abuse) in clients with eating disorders?
What is a common complication related to purging (vomiting and laxative abuse) in clients with eating disorders?
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What is a focus of individual therapy for clients with anorexia nervosa?
What is a focus of individual therapy for clients with anorexia nervosa?
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What is a common medical management focus for clients with anorexia nervosa?
What is a common medical management focus for clients with anorexia nervosa?
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Which body system is affected by medical complications of eating disorders?
Which body system is affected by medical complications of eating disorders?
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What is a common complication related to weight loss in clients with eating disorders?
What is a common complication related to weight loss in clients with eating disorders?
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What is a characteristic of anorexia nervosa clients that can make them difficult to treat?
What is a characteristic of anorexia nervosa clients that can make them difficult to treat?
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What type of therapy can be effective in preventing relapse and improving overall outcomes for anorexia nervosa clients?
What type of therapy can be effective in preventing relapse and improving overall outcomes for anorexia nervosa clients?
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What treatment settings are suitable for anorexia nervosa, depending on the severity of the illness and comorbid conditions?
What treatment settings are suitable for anorexia nervosa, depending on the severity of the illness and comorbid conditions?
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What may be beneficial for families of clients younger than 18 years with anorexia nervosa?
What may be beneficial for families of clients younger than 18 years with anorexia nervosa?
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What can family-based early intervention prevent in clients with anorexia?
What can family-based early intervention prevent in clients with anorexia?
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Melatonin is derived from which amino acid?
Melatonin is derived from which amino acid?
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What is the range of recommended doses for melatonin supplements?
What is the range of recommended doses for melatonin supplements?
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What is the primary influence of melatonin on the body?
What is the primary influence of melatonin on the body?
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Melatonin supplements are widely promoted for the prevention and treatment of which condition?
Melatonin supplements are widely promoted for the prevention and treatment of which condition?
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In which group of individuals did studies show improvement in sleep with melatonin supplements?
In which group of individuals did studies show improvement in sleep with melatonin supplements?
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Melatonin supplements are contraindicated in patients with which condition?
Melatonin supplements are contraindicated in patients with which condition?
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What is the mechanism of action of valerian in treating anxiety and insomnia?
What is the mechanism of action of valerian in treating anxiety and insomnia?
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What did a meta-analysis of 11 clinical trials find about the efficacy of valerian in treating insomnia?
What did a meta-analysis of 11 clinical trials find about the efficacy of valerian in treating insomnia?
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What are the potential adverse effects of valerian?
What are the potential adverse effects of valerian?
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Who should avoid taking valerian?
Who should avoid taking valerian?
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What is a concern associated with long-term use of benzodiazepines?
What is a concern associated with long-term use of benzodiazepines?
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Which benzodiazepine is described as the prototype with a long half-life and wide clinical uses?
Which benzodiazepine is described as the prototype with a long half-life and wide clinical uses?
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What is the recommended duration for long-term treatment of chronic insomnia with eszopiclone?
What is the recommended duration for long-term treatment of chronic insomnia with eszopiclone?
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When should nonbenzodiazepine hypnotics be taken?
When should nonbenzodiazepine hypnotics be taken?
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What is emphasized in patient teaching guidelines regarding the use of sleeping pills?
What is emphasized in patient teaching guidelines regarding the use of sleeping pills?
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What should patients avoid while taking sedative–hypnotic drugs?
What should patients avoid while taking sedative–hypnotic drugs?
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Which drug should not be taken concurrently with alcohol or other CNS depressants?
Which drug should not be taken concurrently with alcohol or other CNS depressants?
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What is the primary purpose of nonbenzodiazepine sedative–hypnotics according to the guidelines?
What is the primary purpose of nonbenzodiazepine sedative–hypnotics according to the guidelines?
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Which symptom is indicative of physical dependence on diazepam?
Which symptom is indicative of physical dependence on diazepam?
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What is an important precaution for patients taking benzodiazepines?
What is an important precaution for patients taking benzodiazepines?
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What is a recommended approach to prevent withdrawal symptoms when discontinuing diazepam-related drugs?
What is a recommended approach to prevent withdrawal symptoms when discontinuing diazepam-related drugs?
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What is a paradoxical response to diazepam?
What is a paradoxical response to diazepam?
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What is an important aspect of patient teaching regarding benzodiazepines?
What is an important aspect of patient teaching regarding benzodiazepines?
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What is an important monitoring consideration when administering diazepam?
What is an important monitoring consideration when administering diazepam?
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Which population should take diazepam only when clearly indicated, in the lowest effective dose, and for the shortest effective time?
Which population should take diazepam only when clearly indicated, in the lowest effective dose, and for the shortest effective time?
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In which population are benzodiazepines metabolized more slowly, and half-lives are longer than in younger adults?
In which population are benzodiazepines metabolized more slowly, and half-lives are longer than in younger adults?
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In which population may diazepam and other benzodiazepines produce paradoxical excitement and aggression, especially in those with a history of psychosis?
In which population may diazepam and other benzodiazepines produce paradoxical excitement and aggression, especially in those with a history of psychosis?
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In which population should caution be exercised due to the potential sensitivity to the effects of diazepam, especially drowsiness, poor coordination, and mental and/or mood changes?
In which population should caution be exercised due to the potential sensitivity to the effects of diazepam, especially drowsiness, poor coordination, and mental and/or mood changes?
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In which population may active metabolites of diazepam accumulate, causing excessive sedation and respiratory depression?
In which population may active metabolites of diazepam accumulate, causing excessive sedation and respiratory depression?
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In which population are antianxiety and sedative–hypnotic drugs often useful to relieve stress, anxiety, and agitation, but caution is necessary with the use of diazepam?
In which population are antianxiety and sedative–hypnotic drugs often useful to relieve stress, anxiety, and agitation, but caution is necessary with the use of diazepam?
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Which age group is most likely to experience slower metabolism of benzodiazepines?
Which age group is most likely to experience slower metabolism of benzodiazepines?
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In which group of patients is benzodiazepine use contraindicated due to the risk of paradoxical excitement and aggression?
In which group of patients is benzodiazepine use contraindicated due to the risk of paradoxical excitement and aggression?
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What condition may lead to excessive sedation and respiratory depression with diazepam use?
What condition may lead to excessive sedation and respiratory depression with diazepam use?
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Which group of patients is diazepam contraindicated in?
Which group of patients is diazepam contraindicated in?
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When are adverse effects of diazepam and other benzodiazepines more likely to occur?
When are adverse effects of diazepam and other benzodiazepines more likely to occur?
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What is an important role of home care nurses in relation to diazepam?
What is an important role of home care nurses in relation to diazepam?
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Study Notes
Medical Complications and Treatment of Eating Disorders
- Medical complications of eating disorders affect multiple body systems including musculoskeletal, metabolic, cardiac, gastrointestinal, reproductive, dermatologic, hematologic, and neuropsychiatric.
- Complications related to weight loss include loss of muscle mass, osteoporosis, hypothyroidism, hypoglycemia, and decreased insulin sensitivity.
- Complications related to purging (vomiting and laxative abuse) include electrolyte abnormalities, salivary gland and pancreas inflammation, esophageal and gastric erosion or rupture, and dental erosion.
- Anorexia nervosa clients can be resistant, uninterested, and deny their problems, making them difficult to treat.
- Treatment settings for anorexia nervosa include inpatient specialty eating disorder units, partial hospitalization or day treatment programs, and outpatient therapy, depending on the severity of the illness and comorbid conditions.
- Major life-threatening complications that indicate the need for hospital admission include severe fluid, electrolyte, and metabolic imbalances; cardiovascular complications; severe weight loss; and risk for suicide.
- Medical management focuses on weight restoration, nutritional rehabilitation, rehydration, and correction of electrolyte imbalances, with severely malnourished clients possibly requiring total parenteral nutrition or tube feedings.
- Cognitive-behavioral therapy (CBT) can be effective in preventing relapse and improving overall outcomes for anorexia nervosa clients.
- Family therapy may be beneficial for families of clients younger than 18 years and can help resolve family issues and improve communication.
- Individual therapy for clients with anorexia nervosa may be indicated in some circumstances, focusing on coping skills, self-esteem, self-acceptance, interpersonal relationships, and assertiveness.
- Enhanced cognitive-behavioral therapy (CBT-E) has been even more successful than CBT for treating anorexia nervosa.
- Family-based early intervention can prevent future exacerbation of anorexia when families are able to participate effectively.
Benzodiazepines and Nonbenzodiazepine Sedative-Hypnotic Agents: Guidelines and Precautions
- Nonverbal behavior is important in assessing response to medication, including decreased heart rate, blood pressure, and relaxed posture
- Assessment of drowsiness, sleep pattern, and monitoring for adverse effects is necessary when administering diazepam
- Paradoxical responses to diazepam may include anger, aggression, and hallucinations
- Symptoms of diazepam dependence, overdose, and withdrawal must be assessed, with withdrawal symptoms indicating physical dependence
- Common withdrawal symptoms include increased anxiety, agitation, insomnia, irritability, headache, tremor, and palpitations
- Less common but serious withdrawal signs include confusion, abnormal perception, depersonalization, psychosis, and seizures
- Patient teaching guidelines emphasize that benzodiazepines provide temporary relief and counseling or psychotherapy may be more beneficial for long-term relief
- Patients are advised to identify and avoid factors causing nervousness, such as caffeine, and to avoid combining benzodiazepines with other drugs
- Patients should not perform tasks requiring alertness if drowsy from medication, and should avoid alcohol and depressant drugs
- Drugs should be stored safely, out of reach of children and adults, and not shared with others
- Gradual discontinuation of diazepam-related drugs under supervision of a healthcare provider is recommended to prevent withdrawal symptoms
- Specific instructions for taking benzodiazepines and nonbenzodiazepine sedative-hypnotic agents, including dosage, administration, and duration, are provided.
Diazepam Nursing Implications and Patient Use
- Children may have paradoxical CNS stimulation and excitement when taking diazepam and other benzodiazepines.
- Diazepam should not be used in children younger than 1 month of age.
- Older adults metabolize benzodiazepines more slowly, and caution is necessary due to potential sensitivity to its effects.
- Benzodiazepine use in patients older than 50 years of age with a history of psychosis may lead to paradoxical excitement and aggression.
- Benzodiazepine use may be related to cognitive declines.
- Impaired renal or hepatic function may lead to excessive sedation and respiratory depression with diazepam use.
- Diazepam is contraindicated in patients with critical illness and in those taking antiretrovirals, certain antibiotics, and blood pressure medications.
- Home care nurses play a vital role in teaching patients how to use diazepam effectively and recognize medication responses that should be reported.
- Adverse effects of diazepam and other benzodiazepines are more likely to occur after 2 or 3 days of therapy and may persist after discontinuation.
- CNS depressant effects of diazepam may lead to adverse effects such as drowsiness, memory problems, and new or worsening seizures.
- Diazepam is contraindicated in people with severe respiratory disorders, severe liver or kidney disease, hypersensitivity reactions, and a history of alcohol or other drug abuse, as well as in those with narrow-angle glaucoma or who are pregnant or breast-feeding.
- Smaller-than-usual doses of diazepam may be necessary in patients receiving cimetidine or other drugs that decrease hepatic metabolism. Nurses must adhere to specific guidelines for administering various preparations of diazepam.
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Description
Test your knowledge of the medical complications and treatment of eating disorders with this informative quiz. Learn about the various body systems affected by eating disorders, complications related to weight loss and purging, treatment settings, medical management, and effective therapeutic approaches. Master the essential information for providing care to individuals with anorexia nervosa and related conditions.
