A patient has dull, almost inaudible breath sounds, and decreased tactile fremitus in the right hemithorax. Which of the following would frequently cause these findings? Atelectesis of the right lower lobe B. Right tension pneumothorax C.
Reducing exercise and eliminating other purging behaviors Recovering health Cognitive-Behavioral Therapy-Enhanced: This treatment was originally designed for bulimia nervosa and is now being used with anorexia nervosa.
CBT-E treatment can involve 20 sessions or 40 sessions over the relative number of weeks, with a follow-up 20 weeks later. CBT-E has four phases: A brief systematic review of progress where plans are made for the main body of treatment. Sessions that focus on helping patients maintain the changes they have made, including developing personalized strategies for rapid correction of setbacks.
Dalle Grave, et al. Subjects exhibited a decrease in eating disorder pathology and general psychiatric features, and had minimal residual pathology. With adolescents, parents were involved in the treatment. Cognitive Remediation Therapy CRT was originally developed to rehabilitate patients who had brain lesions, in order to improve brain functioning.
Because anorexics display the trait of cognitive inflexibility poor set shiftingthis form of therapy is being tailored to treat these patients. CRT is an intensive session training that encourages patients to reflect and modify the way they think. Preliminary evidence for efficacy is limited but encouraging Tchanturia and Hambrook in Grilo and Mitchell, Patients with severe eating disorders respond more slowly to intervention because of intense weight-gain fears.
As food is introduced, obsessive thinking spikes along with awareness of unpleasant emotions. Starvation stops the chatter and the pain.
Giving up what has worked for a long time seems risky. Become creative in finding ways to promote individual changes. To reduce the fear of reintroducing grain carbohydrates, suggest that your patient start out with rice cakes instead of bread.
A patient continues to run even though exercise is banned. Have the patient hand over his running shoes until weight gain is achieved. A patient resists keeping track of daily food intake to stay in denial of how little is actually eaten. Food is optional in the beginning Adams, This can be adapted to outpatient treatment.
The dietician designs meal plans that include liquid meals with food added in at a measured pace.
A patient who is gaining weight on 1, calories per day in the hospital may require 2, calories per day after two weeks and 3, calories per day after six weeks Adams, Once the metabolic rate increases, so do caloric needs. The adjustment is difficult and patients often respond by shaving calories.
This is why a weekly weigh-in is vitally important. It is the only way to tell if your patient is eating everything required by the dietitian. Bed rest can be an effective tool in promoting weight gain. In the hospital, the patient must rest if weight does not increase.
When it does, the patient spends more time out of bed American Psychiatric Association, Teens in outpatient therapy can be taken out of school and placed on bed rest if they do not gain weight.
They can only join regular activities when their weight increases by one to two pounds per week. Exercise abuse is common with anorexics. Therefore, exercise must be adapted to the amount of calories ingested each day, which the dietician can calculate.
Patients will oppose your recommendation to adjust exercise downward. Those who have an actual exercise addiction cannot stop compulsively engaging in their sport of choice. A physical exam will give you and your patient information about how her health is compromised and the role exercise plays.
Guide patients toward the perspective that exercise is for physical fitness and overall health, not burning calories. Tell them that the way they exercise makes them ill.Start studying Eating Disorders.
Learn vocabulary, terms, and more with flashcards, games, and other study tools. Electrolyte imbalance which can cause serious medical complications like would be present in an individual suffering from bulimia. Dorothea Helen Ball (). Dorothea was born in in Lenzie, just outside Glasgow, the eldest of three children.
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Using data from the AHRQ report, the Institute for Clinical and Economic Review (ICER, ) conducted a cost-effectiveness modeling study, assuming that transcranial electrical stimulation and electroconvulsive therapy have equivalent efficacy.
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