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The nurse is caring for a client with anorexia nervosa. What is the most important goal when planning care for this client?
- A. Regain lost weight.
- B. Restore fluid and electrolyte imbalances.
- C. Improve self-esteem and body image.
- D. Support healthy coping mechanisms.
Correct Answer: B
Rationale: In anorexia, electrolyte levels, especially potassium and sodium, are often dangerously low. Cardiac irregularities can be identified on electrocardiogram and are often directly linked to fluid and electrolyte imbalances that can lead to cardiac failure and death. Therefore, it is paramount to correct fluid and electrolyte imbalances. Regaining lost weight, supporting healthy coping mechanisms, and improving self-esteem are all goals that are significant in the management of anorexia.
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The nurse is preparing a teaching plan for a client diagnosed with bulimia nervosa. What would be included in the teaching plan?
- A. Change eating locations frequently
- B. Consume no more than 2000 to 3000 calories/day.
- C. Eat alone to concentrate on food intake.
- D. Consume high-caloric foods.
Correct Answer: B
Rationale: Included in the teaching plan should be that the client will consume no more than 2000 to 3000 calories/day divided among three meals plus or minus snacks. There should be a restriction of eating locations. Binging takes place when the client with bulimia is alone and when there is a low potential for being discovered. Consuming low-caloric foods may create less anxiety and reduce the potential for purging.
A teenager who is attending a clinic for eating disorders has shown improvement in weight, but the laboratory values remain poor. Which behavior would the nurse identify as the likely cause of this finding?
- A. Pushing food around the plate
- B. Inducing vomiting after meals
- C. Drinking water before weighing
- D. Disposing of food
Correct Answer: C
Rationale: Drinking large volumes of water prior to being weighed is manipulative behavior that is likely the cause of improved weight without improved laboratory values. Pushing food around the plate to distort amount of food eaten, inducing vomiting, and disposing of food are all forms of manipulation but would not account for improvement of weight.
What is a true statement regarding anorexia nervosa?
- A. More men are affected with anorexia nervosa.
- B. Increased serotonin levels contribute to overeating.
- C. Clients consume 600 to 900 calories/day.
- D. Due to the psychological impact, clients with anorexia do not feel hungry.
Correct Answer: C
Rationale: Not uncommonly, people with anorexia nervosa consume an average of 600 to 900 calories/day, often less. More women are affected than men. Increased serotonin levels contribute to restricted eating. They get hungry but control the urge to eat because of a morbid fear of becoming fat.
The nurse is providing a teaching seminar to a group of teenagers on the subject of healthy eating. A scale is used to calculate body mass index (BMI) for each individual participant. A participant asks the nurse if a BMI of 25 is normal.
- A. A BMI of 25 is normal.
- B. The BMI formula does not include ratio of fat to muscle mass.
- C. BMI is just one tool for healthy lifestyle.
- D. Keeping your BMI below 30 is ideal.
Correct Answer: C
Rationale: The healthy interpretation of BMI ranges from 18.5 to 24.9. Knowing that teenagers are very susceptible to eating disorders and desire for thinness, the nurse takes the focus off the number (25) and addresses healthy lifestyle. BMI is only one tool used for anthropometric data collection. Ratio of fat to lean muscle mass is not included in BMI. A BMI of 30 is indicative of obesity and would not be considered ideal.
A client is being evaluated for an eating disorder. Which nursing assessment finding(s) is most indicative of a client with bulimia nervosa? Select all that apply.
- A. Younger onset than anorexia nervosa
- B. Denial of abnormal eating habits
- C. Overweight or normal weight
- D. Admits to purging and binging
- E. Eroded teeth enamel
- F. Appears thin but feels fat
Correct Answer: C,D,E
Rationale: In contrast to clients with anorexia nervosa, clients with bulimia nervosa are generally overweight or of normal weight, admit to their eating behavior of binging and purging, and often have erosion of teeth enamel from gastric acid contact. Bulimics are generally older at the onset of the disorder than anorexics. Anorexics are obsessed with thinness and view themselves as fat even when emaciated.