Psychiatric Medications Q 44
Nurse Marco is developing a plan of care for a client with anorexia nervosa. Which action should the nurse include in the plan?
A. Restricts visits with the family and friends until the client begins to eat.
B. Provide privacy during meals.
C. Set up a strict eating plan for the client.
D. Encourage the client to exercise, which will reduce her anxiety.
Correct Answer: C. Set up a strict eating plan for the client.
Establishing a consistent eating plan and monitoring the client’s weight is very important in this disorder. Establish a minimum weight goal and daily nutritional requirements. Malnutrition is a mood-altering condition, leading to depression and agitation and affecting cognitive function and decision-making. Improved nutritional status enhances thinking ability, allowing initiation of psychological work.
Option A: The family and friends should be included in the client’s care. Identify patterns of interaction. Encourage each family member to speak for self. Do not allow two members to discuss a third without that member’s participation. Helpful information for planning interventions. The enmeshed, over-involved family members often speak for each other and need to learn to be responsible for their own words and actions.
Option B: The client should be monitored during meals-not given privacy. Use a consistent approach. Sit with the patient while eating; present and remove food without persuasion and comment. Promote a pleasant environment and record intake. Patient detects urgency and may react to pressure. Any comment that might be seen as coercion provides focus on food. When staff responds in a consistent manner, the patient can begin to trust staff responses. The single area in which the patient has exercised power and control is food or eating, and he or she may experience guilt or rebellion if forced to eat. Structuring meals and decreasing discussions about food will decrease power struggles with the patient and avoid manipulative games.
Option D: Exercise must be limited and supervised. Monitor exercise programs and set limits on physical activities. Chart activity and level of work (pacing and so on). Moderate exercise helps in maintaining muscle tone, weight and combating depression; however, the patient may exercise excessively to burn calories.