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Valproate is an anticonvulsant and mood stabilizer primarily used in the treatment of bipolar disorder and seizure disorders. Its mechanism involves enhancing GABAergic neurotransmission and modulating voltage-gated ion channels. While it can be used for mood stabilization, it is not a first-line treatment for bulimia nervosa. Its side effect profile also differs significantly from SSRIs.

Naltrexone is an opioid antagonist used primarily for alcohol and opioid dependence. It blocks opioid receptors, reducing cravings and the euphoric effects of these substances. It has no direct pharmacological action on the neurochemical pathways associated with appetite regulation or mood disturbances characteristic of bulimia nervosa.

Olanzapine is an atypical antipsychotic primarily used for schizophrenia and bipolar disorder. It blocks dopamine and serotonin receptors. While it can cause weight gain, which might seem counterintuitive in bulimia, its primary therapeutic indications and extensive side effect profile make it an inappropriate first-line choice for bulimia nervosa.

A speech therapist, or speech-language pathologist, is a specialist who diagnoses and treats communication disorders. Their role involves assessing speech, language, and swallowing difficulties, and implementing therapeutic interventions. A nurse's scope of practice does not include providing specialized speech therapy.

A legal representative, such as a lawyer or guardian, is authorized to act on behalf of another person in legal matters. This role is outside the scope of nursing practice, which focuses on providing direct patient care and advocating for health and well-being within ethical and professional guidelines.

A diagnostician, typically a physician or other licensed healthcare professional, is responsible for identifying and naming diseases or conditions based on signs, symptoms, and diagnostic tests. While nurses contribute to the diagnostic process through assessment, they do not independently establish medical diagnoses.

Hyperkalemia, an elevated potassium level (normal range 3.5-5.0 mEq/L), is generally not expected in anorexia nervosa. More commonly, hypokalemia can occur due to purging behaviors like vomiting or laxative abuse, leading to significant electrolyte imbalances. Hyperkalemia would be an atypical finding.

Hyperglycemia, elevated blood glucose levels (normal fasting 70-99 mg/dL), is not a typical finding in anorexia nervosa. Due to chronic caloric restriction and depleted glycogen stores, individuals with anorexia nervosa are more prone to hypoglycemia or euglycemia rather than elevated blood sugar.

Swollen parotid glands, often referred to as sialadenosis, are more commonly associated with bulimia nervosa due to repeated vomiting. The frequent emesis causes hypertrophy of the salivary glands. While not exclusive to bulimia, it is less characteristic of anorexia nervosa without purging behaviors.

The absence of delusions or hallucinations is characteristic of a period of remission or residual phase in psychotic disorders, not the active phase of schizoaffective disorder. During an active phase, both psychotic symptoms and mood symptoms are prominent and co-occur.

While negative symptoms can be present in both schizophrenia and schizoaffective disorder, they are typically more severe and enduring in schizophrenia. The active phase of schizoaffective disorder is defined by the co-occurrence of prominent mood symptoms alongside psychotic features.

Anosognosia, a lack of insight into one's illness, can occur in both schizophrenia and schizoaffective disorder. However, there is no scientific basis to suggest that anosognosia is inherently more severe during the active phase of schizoaffective disorder compared to schizophrenia. Its severity varies individually.

Resources for group therapy are valuable for long-term management of borderline personality disorder, providing skills training and peer support. However, while important, immediate safety concerns, such as the potential for self-harm, take precedence when a new diagnosis is made.

Medication compliance is important for managing co-occurring conditions or specific symptoms in borderline personality disorder, but pharmacological interventions are often adjunctive to psychotherapy. Addressing immediate safety risks associated with self-harm is paramount before focusing on long-term medication adherence.

Information about insurance coverage is practical for accessing treatment, but it is not the immediate priority for a new diagnosis of borderline personality disorder. The most pressing concern for the client and family is understanding the disorder's high-risk behaviors, particularly self-harm, and implementing safety measures.

Illness anxiety disorder involves preoccupation with having or acquiring a serious illness, with somatic symptoms being absent or only mild. The client's action of self-cutting, an overt physical manifestation, does not align with the core features of illness anxiety, which is characterized by excessive health-related anxiety.

Functional neurological symptom disorder, previously conversion disorder, involves neurological symptoms that are inconsistent with known neurological conditions and are not intentionally produced. The client's deliberate act of cutting themselves contradicts the involuntary and neurological nature of this disorder.

Somatic symptom disorder is characterized by one or more distressing or significantly disruptive somatic symptoms, often with excessive thoughts, feelings, or behaviors related to the symptoms. While the client has a physical symptom (lacerations), the explicit statement of intentional self-infliction for boredom distinguishes it from the non-volitional nature of somatic symptom disorder.

Somatic symptom disorder involves experiencing physical symptoms without a clear medical cause, leading to significant distress or functional impairment. The primary focus is on the physical symptoms themselves, rather than a pervasive fear of acquiring a disease, differentiating it from the client's described extreme fear. This disorder often includes excessive thoughts, feelings, or behaviors related to the somatic symptoms.

Functional neurological symptom disorder, also known as conversion disorder, involves neurological symptoms like paralysis or blindness that are inconsistent with known neurological conditions. The distress manifests as a loss of function rather than a fear of acquiring disease or repetitive body checking behaviors. The symptoms are not intentionally produced and are thought to be related to psychological factors.

Factitious disorder is characterized by the falsification of physical or psychological signs or symptoms, or induction of injury or disease, associated with identified deception. The motivation for these behaviors is to assume the sick role, not an actual fear of having or acquiring a disease, nor is it merely repeated body checking due to anxiety. This disorder involves intentional deception.

Somatic symptom disorder is not typically diagnosed in early childhood. While some somatic complaints can appear in childhood, the full diagnostic criteria for somatic symptom disorder, including the associated distress and impairment, usually emerge later in adolescence or early adulthood. Its manifestation in young children often presents differently, primarily as unexplained physical symptoms.

Somatic symptom disorder does not typically have an onset in older adulthood. The average age of onset for somatic symptom disorder is generally in adolescence or early adulthood. While symptoms can persist or fluctuate throughout the lifespan, new onset in older adulthood is less common and warrants thorough medical investigation to rule out organic causes.

There is no diagnostic criterion stating that somatic symptom disorder must be diagnosed before 18 years of age. While it often begins in adolescence, diagnosis can occur at any age when the criteria are met. This disorder's diagnostic timeline is based on the presentation of symptoms and associated distress, not a specific age cut-off for initial diagnosis.

Borderline personality disorder is categorized under Cluster B, which encompasses dramatic, emotional, and erratic behaviors. Key features include instability in relationships, self-image, and affects, along with marked impulsivity. These characteristics fundamentally differ from the anxious and fearful traits that define Cluster C, where dependent personality disorder resides.

Paranoid personality disorder is a Cluster A disorder, characterized by odd or eccentric behaviors. Individuals with this disorder exhibit pervasive distrust and suspiciousness of others, interpreting their motives as malevolent. This pervasive paranoia and social detachment distinguishes it from the anxious and dependent traits seen in Cluster C personality disorders.

Antisocial personality disorder is part of Cluster B, characterized by a pervasive pattern of disregard for and violation of the rights of others. This includes deceitfulness, impulsivity, irritability, and a lack of remorse. These aggressive and manipulative behaviors are distinct from the anxious, fearful, and dependent characteristics associated with Cluster C.

While some medications can affect blood pressure, a primary concern with prescribing sedatives or tranquilizers to older adults with dementia is not typically an increase in blood pressure. The physiological effects of these medications in this population are more commonly associated with central nervous system depression, leading to other significant adverse events, rather than hypertension. Normal blood pressure is typically <120/80 mmHg.

There is no direct scientific link establishing that medications to calm clients with dementia primarily increase their risk for infection. While some medications might indirectly affect the immune system in certain contexts, the main contraindication for using calming medications in dementia patients is not heightened susceptibility to infections. Risk for infection is more related to other factors like immobility or compromised immune status.

While some psychotropic medications can have cardiovascular effects, increasing the risk of stroke is not the primary or most common reason for avoiding calming medications in older adults with dementia. The more immediate and significant concern is the increased risk of falls and other central nervous system-related adverse effects. Stroke risk is influenced by broader cardiovascular health.