Comprehensive exams for Mental Health Q 219
For a female client with anorexia nervosa, Nurse Jimmy is aware that which goal takes the highest priority?
A. The client will establish adequate daily nutritional intake.
B. The client will make a contract with the nurse that sets a target weight.
C. The client will identify self-perceptions about body size as unrealistic.
D. The client will verbalize the possible physiological consequences of self-starvation.
Correct Answer: A. The client will establish adequate daily nutritional intake.
According to Maslow’s hierarchy of needs, all humans need to meet basic physiological needs first. Because a client with anorexia nervosa eats little or nothing, the nurse must first plan to help the client meet this basic, immediate physiological need. Treatment for anorexia nervosa is centered on nutrition rehabilitation and psychotherapy. Refeeding syndrome can occur following prolonged starvation. As the body utilizes glucose to produce molecules of adenosine triphosphate (ATP), it depletes the remaining stores of phosphorus. Also, glucose entry into cells is mediated by insulin and occurs rapidly following long periods without food. Both cause electrolyte abnormalities such as hypophosphatemia and hypokalemia, triggering cardiac and respiratory compromise. Patients should be followed carefully for signs of refeeding syndrome and electrolytes closely monitored.
Option B: Recovery from an eating disorder can be a long process that requires not only a qualified team of professionals but also the love and support of family and friends. It is not uncommon for someone who suffers from an eating disorder to feel uncertain about their progress or for their loved ones to feel disengaged from the treatment process. These potential roadblocks may lead to feelings of ambivalence, limited progress, and treatment dropout.
Option C: Anorexia nervosa is a psychiatric disease in which patients restrict their food intake relative to their energy requirements through eating less, exercising more, and/or purging food through laxatives and vomiting. Despite being severely underweight, they do not recognize it and have distorted body images. They can develop complications from being underweight and purging food. Diagnose by history, physical, and lab work that rules out other conditions that can make people lose weight. Treatment includes gaining weight (sometimes in a hospital if severe), therapy to address body image, and management of complications from malnourishment.
Option D: The nurse may give lesser priority to goals that address long-term plans, self-perception, and potential complications. Eating disorders can affect every organ system in the body, and people struggling with an eating disorder need to seek professional help. The earlier a person with an eating disorder seeks treatment, the greater the likelihood of physical and emotional recovery.