Substance Abuse and Abuse Q 56
The nurse is assessing a 17-year-old female who is admitted to the eating disorders unit with a history of weight fluctuation, abdominal pain, teeth erosion, receding gums, and bad breath. She states that her health has been a problem but there are no other concerns in her life. Which of the following assessments will be the least useful as the nurse develops the care plan?
A. Information regarding recent mood changes
B. Family functioning using a genogram
C. Ability to socialize with peers
D. Whether she has a sexual relationship with a boyfriend
Correct Answer: D. Whether she has a sexual relationship with a boyfriend
It is inappropriate to ask about her sexual relationships. Encourage personal development program, preferably in a group setting. Provide information about the proper application of makeup and grooming. Learning about methods to enhance personal appearance may be helpful to a long-range sense of self-esteem and image. Feedback from others can promote feelings of self-worth.
Option A: Information about mood changes is important to assess, as bulimia is often associated with affective disorders. Listen to or avoid challenging irrational, illogical thinking. Present reality concisely and briefly. It is difficult to respond logically when thinking ability is physiologically impaired. The patient needs to hear reality, but challenging the patient leads to distrust and frustration. Even though the patient may gain weight, she or he may continue to struggle with attitudes or behaviors typical of eating disorders, major depression, or alcohol dependence for a number of years.
Option B: Family functioning is the most essential point to assess, as it reveals if binge eating is triggered by conflict within the family. 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 C: Information about the ability to socialize with peers is important to assess, as it is possible the problem initiated with peer relationships. Let the patient know that it is acceptable to be different from family, particularly mother. Developing a sense of identity separate from family and maintaining a sense of control in other ways besides dieting and weight loss is a desirable goal of therapy and program.