A nurse is educating a patient with an eating disorder about the treatment options. Which statement made by the patient indicates a need for further teaching?

Choice A rationale:

Allowing the client to continue avoiding meals to reduce stress is not a suitable nursing intervention. It perpetuates the unhealthy behavior and does not contribute to the client's recovery.

Choice B rationale:

Providing positive reinforcement for not eating to encourage progress is also not appropriate. Positive reinforcement should be directed towards healthy behaviors rather than reinforcing the avoidance of meals.

Choice C rationale:

Supervising meals and snacks to prevent food refusal or hiding is an essential nursing intervention. Patients with eating disorders often engage in secretive behaviors related to food, so supervision helps ensure that they are receiving the necessary nutrition and support their recovery.

Choice D rationale:

Advising the client to eat alone to avoid social pressure is not a recommended intervention. Eating disorders thrive on isolation, and encouraging the client to eat alone could exacerbate the issue.

Choice A rationale:

Bradycardia and tachycardia. While these cardiovascular symptoms can occur in eating disorders, they are more commonly associated with anorexia nervosa rather than bulimia nervosa. Bradycardia (slow heart rate) is often seen in individuals with severe anorexia due to the body's adaptive response to conserve energy. Tachycardia (rapid heart rate) can occur as a compensatory mechanism in response to dehydration and electrolyte imbalances, particularly in those with anorexia. However, in bulimia nervosa, the rapid cycle of binge eating and purging is more likely to lead to electrolyte imbalances that cause other symptoms.

Choice B rationale:

Hypertension and mitral valve prolapse. Hypertension (high blood pressure) is not a common cardiovascular symptom of bulimia nervosa. Mitral valve prolapse, which involves the improper closing of the heart's mitral valve, is also not a typical cardiovascular manifestation of bulimia nervosa. Eating disorders primarily affect the electrical conduction system of the heart and can lead to rhythm disturbances.

Choice C rationale:

Orthostatic hypotension and arrhythmias. This is the correct choice. Orthostatic hypotension, which is a drop in blood pressure upon standing, is a common cardiovascular symptom of bulimia nervosa. It is often a result of dehydration and electrolyte imbalances caused by frequent vomiting and laxative use. Arrhythmias (irregular heart rhythms) can also occur due to electrolyte imbalances, particularly low levels of potassium, which can disrupt the heart's electrical activity.

Choice D rationale:

Pericardial effusion and cardiomyopathy. While pericardial effusion (accumulation of fluid around the heart) and cardiomyopathy (disease of the heart muscle) can occur in individuals with eating disorders, they are not the most common cardiovascular symptoms. These conditions usually result from prolonged malnutrition and severe electrolyte imbalances, which can occur in both anorexia nervosa and bulimia nervosa. However, orthostatic hypotension and arrhythmias are more characteristic of bulimia nervosa.