Assessment of a client reveals severe and sudden mood swings from mania to depression. Which diagnosis should the nurse suspect?

C This is a common and potentially life-threatening complication in individuals with anorexia nervosa who are undergoing treatment. It can lead to cardiac arrhythmias.

A. Anorexia nervosa can lead to electrolyte imbalances, including hyponatremia (low serum sodium level), due to inadequate intake of sodium and fluid restriction. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can also contribute to hyponatremia by causing the syndrome of inappropriate antidiuretic hormone secretion (SIADH), which leads to water retention and dilutional hyponatremia. However, it is not as life-threatening as hypokalemia.

B. Anorexia nervosa can lead to electrolyte imbalances, including hyponatremia (low serum sodium level), due to inadequate intake of sodium and fluid restriction. However, it is not as life-threatening as hypokalemia.

D. Anorexia nervosa typically does not lead to hyperkalemia (high serum potassium level), as potassium is usually lost through purging behaviors or inadequate intake. Antidepressants also do not commonly cause hyperkalemia as a side effect.

A. This response acknowledges the client's feelings of helplessness, which can validate her experience and promote further discussion about her emotions and challenges related to her eating disorder. It shows empathy and encourages the client to explore her feelings.

B. While this question is open-ended and invites the client to explore the underlying reasons for her behavior, it might inadvertently suggest that the client should have insights or control over her behavior that she may not currently possess. It could potentially make the client feel blamed or misunderstood if she cannot provide a clear answer.

C. This response is directive and judgmental, which can lead to the client feeling criticized or defensive. It does not acknowledge the complexity of the client's experience and may not be effective in building rapport or promoting trust between the nurse and client.

D This response acknowledges the client's self-awareness and validates her recognition of the problem, which can be empowering and supportive. It reinforces the positive step the client has taken in acknowledging the issue without placing blame or judgment.