A nurse is caring for a client who has anorexia nervosa. Which of the following findings requires immediate intervention by the nurse?
Lanugo covering the body
+2 edema of the lower extremities
BUN 21 mg/dL
Blood pH 7.60
The Correct Answer is D
A blood pH of 7.60 indicates alkalosis, which is a life-threatening condition that can result from vomiting, laxative abuse, or diuretic use in clients who have anorexia nervosa. Alkalosis can cause cardiac arrhythmias, seizures, coma, and death if not corrected promptly. The nurse should notify the provider and prepare to administer IV fluids and electrolytes as ordered. The other findings are also concerning, but they are not as urgent as alkalosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Transference is a defense mechanism in which the client unconsciously transfers feelings, attitudes, or impulses from a past relationship to a current one, such as a health care provider. The nurse should recognize this behavior and maintain professional boundaries with the client. The other options are not specific to transference and may indicate other issues.
Correct Answer is B
Explanation
A client who has anorexia nervosa is at risk for cardiac arrhythmias due to electrolyte imbalances, dehydration, and malnutrition. The client's statement of feeling their heart jumping in their chest indicates a possible irregular heartbeat that should be reported to the provider. Edema, temperature, and intake are not as urgent as heart rhythm in this case.
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