Which client would the nurse expect to prepare for electroconvulsive therapy (ECT)?

A. Severely restricted food intake can lead to imbalances in electrolytes such as potassium, sodium, and chloride. These imbalances can disrupt normal heart rhythm (arrhythmias) and other vital functions, potentially leading to cardiac arrest, which is a common cause of death in individuals with anorexia nervosa.

B. Individuals with anorexia nervosa are at increased risk of suicidal thoughts and behaviors. This risk may be due to the severe psychological distress associated with the disorder, as well as the physical complications that can feel overwhelming. Suicide can unfortunately be a tragic consequence in some cases.

D Dehydration is a significant risk in individuals with anorexia nervosa, especially when combined with electrolyte imbalances. Dehydration can lead to organ failure, particularly kidney failure, which can be life-threatening if not promptly treated.

E. Severe muscle wasting can occur in individuals with anorexia nervosa, particularly in later stages of the disorder. Loss of muscle mass contributes to overall physical weakness and compromises essential bodily functions, potentially leading to organ failure and death.

C. Anorexia nervosa itself does not directly cause diabetes. However, individuals with severe anorexia may develop metabolic disturbances, including insulin resistance, due to malnutrition. This can lead to abnormal blood sugar levels, but diabetes as a direct cause of death in anorexia is less common compared to other complications.

B. This is the most appropriate initial action. One-to-one observation ensures constant monitoring of the client's safety and prevents further harm, such as another suicide attempt or self-harm. Given the client's history of depression and recent suicide attempt, ensuring their safety is paramount.

A. This option is not the first priority because while addressing anorexia nervosa is important, safety concerns related to the suicide attempt and potential substance abuse take precedence. Making a weight gain contract requires the client's cooperation and readiness, which may not be feasible immediately upon admission.

C. While assessing the severity of depression is crucial, it is secondary to ensuring immediate safety in this context. The client's safety must be established first through continuous observation and intervention.

D. While important to understand the substances involved in the suicide attempt, this action is secondary to ensuring ongoing safety through direct observation. Toxicology results can guide subsequent treatment decisions but are not as urgent as immediate safety measures.