A nurse is caring for a client.

Exhibits

The nurse is collecting data from the client 12 hr. later. How should the nurse interpret the following findings?
For each potential finding, specify whether the finding is an indication of potential improvement or an indication of potential worsening condition.

Choice A: Encourage the client to spend time with others in the dayroom.
Encouraging a client experiencing mania to spend time with others in the dayroom might not be the best approach. Clients with mania often have heightened energy levels and may exhibit impulsive or disruptive behavior. This can lead to conflicts or overstimulation, which can exacerbate their condition. Instead, a more controlled and calm environment is usually recommended to help manage their symptoms effectively.

Choice B: Allow the client to choose activities for the day.
While allowing clients to have some autonomy can be beneficial, clients experiencing mania may have difficulty making appropriate decisions due to their heightened state. They might choose activities that are overly stimulating or unsafe. Structured and guided activities are generally more appropriate to ensure the client's safety and well-being during manic episodes.

Choice C: Be specific when explaining care to the client.
Being specific when explaining care to a client with mania is crucial. Clear and concise instructions help reduce confusion and anxiety, providing a sense of structure and predictability. This approach can help the client understand what to expect, which can be calming and help manage their symptoms more effectively. Specific instructions also ensure that the client follows the care plan accurately, which is essential for their treatment and safety.

Choice D: Redirect client behavior by initiating physical exercise.
Redirecting client behavior by initiating physical exercise can be beneficial, as it helps channel the client's excess energy in a positive way. However, it should be done in a controlled manner to prevent overstimulation or exhaustion. Physical exercise can be a part of the therapeutic plan, but it should be balanced with other interventions to ensure the client's overall well-being.

Choice A: Hypomagnesemia
Hypomagnesemia, or low magnesium levels, is a common finding in clients with bulimia nervosa. This condition often results from frequent vomiting and the use of laxatives or diuretics, which can lead to significant electrolyte imbalances. Magnesium is crucial for many bodily functions, including muscle and nerve function, and its deficiency can cause symptoms such as muscle cramps, weakness, and irregular heartbeats.

Choice B: Muscle wasting
Muscle wasting is another expected finding in clients with bulimia nervosa. The cycle of bingeing and purging can lead to severe nutritional deficiencies, including protein deficiency, which is essential for muscle maintenance. Over time, the body starts breaking down muscle tissue to meet its energy needs, leading to muscle wasting. This can result in weakness, fatigue, and a decrease in physical strength.

Choice C: Lanugo
Lanugo, a fine, soft hair that covers the body, is more commonly associated with anorexia nervosa rather than bulimia nervosa. Lanugo develops as the body's response to extreme weight loss and low body fat, attempting to insulate and maintain body heat. While clients with bulimia may experience significant weight fluctuations, lanugo is not a typical finding in this condition.

Choice D: Hypokalemia
Hypokalemia, or low potassium levels, is a frequent finding in clients with bulimia nervosa. This condition is often caused by repeated vomiting, which leads to the loss of potassium from the body. Potassium is vital for proper muscle function, including the heart muscle, and its deficiency can cause symptoms such as muscle weakness, cramps, and potentially life-threatening cardiac arrhythmias.