A nurse in an outpatient setting is caring for a client.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
The Correct Answer is []
Potential Condition
Bulimia nervosa: The client has a BMI of 18.5, which is on the lower end of normal, indicating possible weight issues, but not the severe underweight typical of anorexia nervosa. The client describes cycles of binge eating followed by compensatory behaviors such as purging (using laxatives), which are characteristic of bulimia nervosa. The client expresses a preoccupation with food and body weight, and feelings of embarrassment about their eating habits, which align with bulimia nervosa.
Actions to Take
1. Assess binging and purging patterns: It's crucial to understand the frequency, triggers, and methods of binging and purging to tailor interventions effectively and to monitor the severity and progression of bulimia.
2. Encourage client to identify triggers for overeating: Identifying triggers for binging can help the client develop healthier coping mechanisms and reduce the occurrence of binge eating episodes.
Parameters to Monitor
1. Electrolyte levels: Frequent use of laxatives and purging behaviors can lead to electrolyte imbalances, which are potentially life-threatening and must be monitored regularly.
2. Frequency of compensatory behaviors: Tracking the frequency of purging behaviors (such as laxative use) helps assess the effectiveness of interventions and the client’s progress in reducing harmful behaviors.
Incorrect answers:
Actions to Take:
- Assess for and discourage provocative or seductive behaviour: This is more relevant to histrionic personality disorder, not bulimia nervosa.
- Weigh daily for the first week: While weighing the client can be part of the monitoring process, daily weigh-ins can increase anxiety and may not directly address the core issues of bulimia.
- Assess for consumption of right food items: While dietary intake is important, focusing solely on food items without addressing the psychological aspects may not be effective for treating bulimia.
Parameters to Monitor:
- Attention-seeking behaviours: More relevant to histrionic personality disorder than bulimia nervosa.
- Signs of infection: Not directly relevant unless there is evidence of a related health issue or a compromised immune system, which is not indicated in the provided information.
- Presence of lanugo: Lanugo is more commonly associated with anorexia nervosa due to severe malnutrition, not bulimia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Follow the established protocol for reporting suspected child abuse or neglect to the appropriate authorities: This is the correct approach according to child protection guidelines. School personnel are mandated reporters and must report suspected abuse or neglect to protect the child's safety.
B. Convince the child to disclose the cause of the injuries through gentle questioning and persuasion: This approach can inadvertently pressure the child and is not recommended as it may lead to further distress or inaccurate information.
C. Respect the child's privacy and wait for them to share information about the injuries voluntarily: While respecting privacy is important, child protection takes precedence when there are signs of abuse or neglect.
D. Document and discuss the observations with the child's teacher to gather more information: While documentation is important, it should not delay reporting suspected abuse or neglect to the appropriate authorities.
Correct Answer is C
Explanation
A. Amenorrhea: This is more commonly associated with anorexia nervosa rather than bulimia nervosa.
B. Hyperkalaemia: Bulimia nervosa is more likely to cause hypokalemia due to frequent vomiting, which leads to loss of potassium.
C. Dental decay: Frequent vomiting exposes teeth to stomach acid, leading to erosion of dental enamel and subsequent decay.
D. Lower than normal expected reference range of body weight: While some individuals with bulimia nervosa may have a low body weight, many maintain a normal weight or may even be overweight.
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