A client diagnosed with anorexia nervosa is newly admitted to an inpatient psychiatric unit. Which nursing intervention takes priority?

Choice A reason: SSRIs increase serotonin levels in the brain, effectively managing GAD with a low risk of dependence. Side effects like nausea or headache are generally mild and transient, making SSRIs safer compared to other classes, as they do not cause significant physiological dependence or severe adverse effects.

Choice B reason: Tricyclic antidepressants affect multiple neurotransmitters, effectively treating GAD but with significant side effects like anticholinergic effects (dry mouth, constipation) and potential cardiotoxicity. They carry a higher risk of overdose and side effects compared to SSRIs, making them less safe for long-term use in GAD.

Choice C reason: Benzodiazepines enhance GABA activity, providing rapid anxiety relief but with a high risk of physiological dependence and withdrawal. Side effects like sedation and cognitive impairment, along with abuse potential, make them less safe than SSRIs for long-term GAD management.

Choice D reason: MAOIs inhibit monoamine oxidase, increasing neurotransmitter levels for GAD treatment. However, they have significant side effects, including hypertensive crises from dietary tyramine, and require strict dietary restrictions. Their risk profile and potential for severe interactions make them less safe than SSRIs.

Choice A reason: Binging involves consuming large amounts of food, often leading to abdominal discomfort, bloating, or nausea. These symptoms are primarily gastrointestinal and do not directly cause hallucinations, restlessness, or dry mucous membranes, which are more indicative of systemic physiological imbalances, making this choice less likely as the primary cause.

Choice B reason: Frequent vomiting in bulimia nervosa causes significant dehydration and electrolyte imbalances, such as hypokalemia or hyponatremia. These disrupt neurological function, leading to hallucinations due to altered brain signaling, restlessness from nervous system irritability, and dry mucous membranes from fluid loss, making this the most likely cause of the symptoms.

Choice C reason: Mood disorders like depression or anxiety are common in bulimia nervosa and may contribute to emotional instability. However, they are less likely to directly cause hallucinations or physical symptoms like dry mucous membranes, which are more closely tied to physiological disruptions from dehydration or electrolyte imbalances.

Choice D reason: Nutritional deficits in bulimia nervosa result from purging or irregular eating, potentially causing fatigue or weakness. However, hallucinations and restlessness are more directly linked to acute electrolyte imbalances from vomiting rather than chronic nutritional deficiencies, which typically present with less acute neurological symptoms.