Wt should be in a gown & weight backwards, don’t share vitals or wt with them Nutritional shake should be poured in a cup, give all napkins back, cannot exercise, canot leave bed/go to bathroom 30 min after meal, supervised meals Highest mortality of all mental disorders Often begins in early adolescence Food restriction, irrational fear of weight gain, distorted body image, excessive weight loss Can include excessive exercising Self harm behaviors Symptoms of OCD, depression and anxiety Physical symptoms: Bradycardia, abnormal cardiac rhythm (hypokalemia), hypotension, amenorrhea, hypothermia, delayed capillary refill and blue fingernails, brittle hair, lanugo, osteoporosis Bulimia Nervosa Consumption of large amounts of food in a short period of time, followed by an attempt to rid the body of that food (purge) through vomiting, excessive exercise, laxative use Often overlaps with anorexia Can have normal BMI as opposed to anorexia where there is a drastic decrease in body weight Physical symptoms can include cardiac rhythm disturbances, bradycardia, irregular menses, scarring on the fingers, hair loss, dental abnormalities Female Athlete Triad Disordered eating, amenorrhea and osteoporosis Essentially anorexia but seen in athletes in sports that emphasis thin frame (ballet, cross country, gymnastics, etc.)
Generally due to the pressure of the sport/coach/teammates/self rather than a more complex underlying problem Eating Disorder Treatment Therapy (group, family, cognitive behavioral) Monitored meals Fluid/electrolyte replacement Close monitoring of weight SSRIs Substance Abuse Sharing meds/selling prescriptions, cig has declined 1 in 5 high schoolers have abused a Rx drug to get high Rx pain killers are the #1 entry level drug Drug abuse before age 16 increases the likelihood of dependency later in life Rx/OTC drugs are easy to access and often free to the adolescent, so teens use them even if they wouldn’t touch illegal drugs Increases risk for motor vehicle accidents and accidental death due to risk taking behaviors Substance Abuse Most abused substances: o Narcotics (Vicodin, Morphine Percocet, Codeine o Depressants (Valium, Xanax) o Stimulants (Adderall, Ritalin, Concerta) o OTCs (cough suppressants, Tylenol, ASA) May combine any of the above with each other or ETOH, illegal drugs Substance Abuse, Continued Adolescents, like adults, will often use substances to self-medicate for unwanted feelings The earlier a child or adolescent is exposed to alcohol or other illicit substances, the higher the likelihood of chemical dependence later in life This is further confounded if there is a family history of substance abuse
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- Spring '17