Alzheimer’s Delirium and Dementia Q 57
Which nursing diagnosis is most appropriate for a client with anorexia nervosa who expresses feelings of guilt about not meeting family expectations?
A. Anxiety
B. Disturbed body image
C. Defensive coping
D. Powerlessness
Correct Answer: D. Powerlessness
The client with anorexia typically feels powerless, with a sense of having little control over any aspect of life besides eating behavior. Often, parental expectations and standards are quite high and lead to the clients’ sense of guilt over not measuring up. Promote self-concept without moral judgment. Patient sees herself as weak-willed, even though part of a person may feel a sense of power and control (dieting, weight loss).
Option A: Assist the patient to assume control in areas other than dieting and weight loss such as management of their own daily activities, work, and leisure choices. Feelings of personal ineffectiveness, low self-esteem, and perfectionism are often part of the problem. The patient feels helpless to change and requires assistance to problem-solve methods of control in life situations.
Option B: Allow the patient to draw a picture of self; provides an opportunity to discuss the patient’s perception of self and body image and realities of an individual situation. Suggest disposing of “thin” clothes as weight gain occurs. Recommend consultation with an image consultant; provides an incentive to at least maintain and not lose weight. Removes visual reminder of thinner self. Positive image enhances a sense of self-esteem.
Option C: Encourage the patient to take charge of their own lives in a more healthful way by making their own decisions and accepting self as she or he is at this moment (including inadequacies and strengths). Patient often does not know what she or he may want for herself. Parents (mother) often make decisions for the patient. Patient may also believe she or he has to be the best in everything and holds self-responsible for being perfect.