A nurse in a mental health facility is caring for a client whose adult child states, "I feel guilty about admitting them to the facility." Which of the following responses should the nurse make?

Choice A reason: Reaching an appropriate body weight is a long-term goal, not a short-term one. Clients with anorexia nervosa require gradual weight restoration to avoid complications such as refeeding syndrome. Setting this as a short-term goal is unrealistic and potentially unsafe.

Choice B reason: Gaining 2 to 3 lb weekly is the correct short-term goal because it is measurable, realistic, and safe. This gradual increase helps stabilize the client’s nutritional status while minimizing medical risks. It also provides a tangible benchmark for progress during inpatient treatment.

Choice C reason: Verbalizing a realistic body image is important but represents a long-term psychosocial goal. Distorted body image is a core feature of anorexia nervosa and requires extended therapy and counseling. It cannot be expected as a short-term outcome during initial hospitalization.

Choice D reason: Developing a personalized meal plan is a collaborative long-term strategy involving dietitians and therapists. While important, it is not the immediate short-term focus. The priority is safe, gradual weight gain.

Choice A reason: Potassium level is the most critical factor to review before administering digoxin. Hypokalemia increases the risk of digoxin toxicity because low potassium levels enhance digoxin’s binding to myocardial tissue, leading to exaggerated effects and potentially life-threatening arrhythmias. Monitoring serum potassium ensures safe administration and prevents complications such as bradycardia, heart block, or ventricular arrhythmias.

Choice B reason: Current weight is important in monitoring fluid status in heart failure, as sudden weight gain may indicate fluid retention. However, weight does not directly determine whether digoxin should be withheld. Digoxin dosing is not based on daily weight changes but rather on renal function and electrolyte balance. Therefore, while weight is clinically relevant in heart failure management, it is not the deciding factor for digoxin administration.

Choice C reason: Hemoglobin level reflects oxygen-carrying capacity and can indicate anemia, which may worsen heart failure symptoms. However, hemoglobin levels do not influence digoxin metabolism or toxicity risk. Anemia management is important for overall cardiac function, but hemoglobin is not a parameter that determines whether digoxin should be administered.

Choice D reason: Liver function is important for many medications metabolized hepatically, but digoxin is primarily excreted unchanged by the kidneys. Therefore, renal function is more relevant than liver function in determining digoxin safety. Liver impairment does not significantly alter digoxin clearance, so this is not the most critical factor to review before administration.