A nurse is collecting data from a client who reports cessation of nicotine use. Which of the following manifestations should the nurse expect? (Select all that apply.)

Choice A reason: Hypokalemia, or low potassium levels in the blood, is a common finding in individuals with bulimia nervosa, especially those who engage in frequent vomiting or use laxatives. Purging behaviors can lead to significant electrolyte imbalances, including potassium depletion, which can cause muscle weakness, cramps, and cardiac arrhythmias. Monitoring potassium levels is crucial in managing the health of individuals with bulimia nervosa.

Choice B reason: Leukopenia, or a low white blood cell count, is not typically associated with bulimia nervosa. While malnutrition and other complications of eating disorders can affect the immune system, leukopenia is more commonly linked to conditions such as infections, autoimmune disorders, or certain medications.

Choice C reason: Decreased serum amylase is not a typical finding in bulimia nervosa. In fact, elevated serum amylase levels are more commonly observed due to the stress on the salivary glands from frequent vomiting. Hyperamylasemia can be an indicator of purging behaviors and should be monitored in individuals with bulimia nervosa.

Choice D reason: Hematuria, or the presence of blood in the urine, is not commonly associated with bulimia nervosa. While hematuria can result from various conditions, including urinary tract infections, kidney stones, or other renal issues, it is not a typical finding in individuals with bulimia nervosa.

Choice A reason: This response shifts the focus from the client to the nurse, which is not therapeutic in this context. The client needs the opportunity to express their own feelings and experiences rather than hearing about the nurse's personal history. It is important for the nurse to remain professional and centered on the client's needs during conversations about grief and depression.

Choice B reason: Encouraging the client to start participating in usual activities might be premature, especially if they are not ready. Grief is a process that takes time, and clients need to move at their own pace. Instead, it is more supportive to listen and validate their current feelings rather than pushing them to resume normal activities too soon.

Choice C reason: Saying that "everyone feels depressed during the grieving process" can invalidate the client's unique experience and feelings. While it is true that grief is common after a loss, the intensity and way it manifests can vary greatly among individuals. This response may come across as dismissive, implying that the client's feelings are not important or unique.

Choice D reason: Asking the client to talk about their relationship with their partner is a therapeutic approach. This response invites the client to share their memories and feelings, which can help in processing their grief. It shows empathy and provides a safe space for the client to express their emotions, fostering a supportive and healing environment.