Rоutine trаumа screening is recоmmended оnly аfter a child shows severe behavioral problems.
Mаintаining pаtient cоnfidentiality is a requirement under [BLANK-1] guidelines.
Initiаl Pоst оn Bulimiа Nervоsа Bulimia nervosa is commonly known as an eating disorder in which one forcibly vomits, uses diuretic supplements, does extreme fasting, or partakes in excessive physical activity. However, as stated in the book Davis Advantage for Pathophysiology, bulimia nervosa (BN) is categorized into two groups. Some individuals will binge eat large amounts of food in short periods. Other individuals consume food only to purge themselves of it minutes later to avoid weight gain (Capriotti, 2020). Although this particular disorder is known to be most prevalent in adolescent women, it impacts a much more comprehensive range of individuals. According to the Cleveland Clinic, “Between 1% and 2% of people will experience bulimia during any given year.” (Cleveland Clinic, 2022). Etiology and Genetic Risk Unlike many other diseases and disorders, there is no genetic risk involved in bulimia nervosa, nor is there a clear etiology. However, the Cleveland Clinic states, “If you have a relative that has or had an eating disorder, you’re at higher risk of developing one yourself.” (Cleveland Clinic, 2022). BN can be associated with anxiety, which can be inherited genetically. Although this link can be made, this disorder has no genetic cause. BN is primarily a psychological condition impacted by environmental stressors and neurological irregularity. One’s self-view, as well as the exterior stressors, are involved in the development of bulimia nervosa. Although BN has no set etiology, neurological irregularities have played a significant part. One such neurological etiology involves abnormalities in one’s insula in the cerebral cortex (Jain & Yilanli, 2020). Another neurological cause is cerebral maturation, which has not fully occurred. As stated previously, adolescents are the most at risk for BN, and that can be caused by the brain not being fully developed. This lack of development can cause an inability to control emotions, reactions, and body dysmorphia (Mele et al., 2020). Physical Assessment/Clinical Manifestations Multiple physical and psychological complications come from bulimia nervosa. A patient with BN will suffer from abdominal pain caused by frequent contractions as well as the use of diuretics. The patient may also experience acid reflux and vomiting after consuming any amount of food or drink. Erosion of teeth and swollen cheeks or jawline can occur due to consistent exposure to the acidic content of the stomach. Hair loss, acrocyanosis, and edema are frequently seen due to lack of circulation, nutrition, and dehydration. Dehydration is a prevalent symptom that can lead to the syncope of a patient. If not treated, dehydration can lead to more severe side effects and possibly even death (Cleveland Clinic, 2022). A lack of proper nutrients can cause muscle weakness the body needs and the dehydration frequently experienced by those with BN. In women, irregular menstrual cycles are typical due to nutritional restrictions. Bulimia nervosa can begin due to anxiety, but it can also cause anxiety. An individual who binge eat or purge themselves may feel severe guilt or embarrassment. These feelings can become overwhelming and could lead to depression. Current Clinical Practice Standards for Diagnostic Assessment of Bulimia Nervosa In order to determine the complexity of the patient’s disorder, a complete physical exam must occur. This physical exam includes checking one’s vital signs to ensure that heart rate, blood pressure, body temperature, and respiratory rate are regular (Hay, 2020). Then, a physician will take the patient’s weight and height and evaluate their BMI and the appropriate BMI for their age. Along with a physical examination, multiple lab tests must be done routinely. These lab tests include a blood test, serum chemistry, and urine test (Hay, 2020). A psychiatric assessment may be necessary as bulimia can cause severe emotional and mental problems for an individual. Getting the physical, lab, and psychiatric examinations can assist in getting the patient the physical and emotional help they need. Treatment options vary for what the individual patient needs. These treatments include cognitive-behavioral therapy, medication, clinics designated for patients with eating disorders, and developing self-care routines for the patient (Eating Disorders: Treatment Options and How to Get Help, 2016). Psychotherapy involves one-on-one counseling with a professional. This treatment would focus on how the patient thinks and behaves regarding food and weight (Cleveland Clinic, 2022). In the role of medication, second-generation antidepressants, and lisdexamfetamines have shown slight but not total improvement (Hay, 2020). It is essential to mix pharmaceutical and psychiatric therapy in order to get the most effective results. Although there are no direct medications for eating disorders, the medicines target the symptoms and side effects that come with them. Clinics for those struggling with eating disorders are beneficial in holding one accountable as well as providing a support system for those getting through an eating disorder. There are different forms of clinics, ranging from outpatient programs to inpatient care. When creating a self-care routine, patients consult a dietician to create a specific nutrition plan. These routines can help BN individuals rebuild their physical and mental well-being. References Capriotti, T. M. (2020). Pathophysiology: introductory concepts and clinical perspectives. (2nd ed.). F A Davis. Cleveland Clinic. (2022, May 16). Bulimia Nervosa: Signs & Symptoms, Complications & Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9795-bulimia-nervosa Eating Disorders: Treatment Options and How to get Help. (2016, May 17). Psych Central. https://psychcentral.com/eating-disorders/eating-disorders-treatment#treatments Hay, P. (2020). Current approach to eating disorders: a clinical update. Internal Medicine Journal, 50(1), 24–29. https://doi.org/10.1111/imj.14691 Jain, A., & Yilanli, M. (2020). Bulimia Nervosa. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK562178/ Mele, G., Alfano, V., Cotugno, A., & Longarzo, M. (2020). A broad-spectrum review on multimodal neuroimaging in bulimia nervosa and binge eating disorder. Appetite, 151, 104712. https://doi.org/10.1016/j.appet.2020.104712
Which оf the fоllоwing is NOT one of the three trаditionаl components of quаlity measurement?