A nurse in a mental health clinic is assessing a client who was recently diagnosed with anorexia nervosa. Which of the following findings should the nurse identify as an indication of laxative misuse?

A. Implement firm but flexible boundaries in their relationship: Establishing boundaries helps both the client and adult child adapt to new caregiving roles while maintaining mutual respect and autonomy. Flexibility allows for adjustments as the client’s needs change, reducing role strain and promoting a healthy family dynamic.

B. Encourage authoritative communication from the adult child: While clear communication is important, an authoritative style may be perceived as controlling and can create tension. Collaborative, respectful communication is more effective in supporting role adjustment and maintaining family harmony.

C. Decrease socialization with extended relatives until roles are identified: Limiting social interactions is unnecessary and may increase isolation or stress. Maintaining connections with extended family can provide emotional support and resources during the transition.

D. Minimize open discussion regarding the changes to avoid embarrassment: Avoiding discussion about changes can lead to misunderstandings, unmet needs, and emotional strain. Open, honest communication helps clarify expectations, reduce conflict, and facilitate adjustment to new roles.

A. Maintain a constant, gentle suction on the drainage device: A portable wound bulb suction device is used to remove blood and serous fluid, prevent hematoma or seroma formation, and promote wound healing. Maintaining constant, gentle suction ensures effective drainage and reduces the risk of complications such as infection or fluid accumulation.

B. Place the client in the supine position while resting in bed: After a mastectomy, clients are typically positioned with the head of the bed elevated and the affected arm supported on a pillow to reduce swelling and promote comfort. Supine positioning without support may increase tension on the surgical site and impair drainage.

C. Prepare to remove the drainage tube 24 hr after the procedure: Drainage tubes are usually removed when output is minimal, often 24–48 hours or longer depending on the volume and type of drainage. Removing the tube at a fixed 24-hour mark may be premature and could increase the risk of fluid accumulation.

D. Notify the provider for drainage of 25 mL in 24 hr: Drainage of 25 mL in 24 hours is minimal and typically does not require provider notification. Normal early postoperative drainage is expected, and the nurse should continue routine monitoring and documentation rather than escalate care for this amount.