Substance Abuse, Eating Disorders, Impulse Control Disorders no. 5028

Substance Abuse, Eating Disorders, Impulse Control Disorders no. 5028

QUESTION: A severely dehydrated teenager admitted to the hospital with hypotension and tachycardia undergoes evaluation for electrolyte disturbances. Her history includes anorexia nervosa and a 20-lb (9.1-kg) weight loss in the last month. She is 5<font face="LWWSYM">X</font> 7" (1.7 m) tall and weighs 80 lb (36.3 kg). Which nursing intervention takes highest priority?

✓O a.) Initiating caloric and nutritional therapy as ordered
✘O b.) Instituting behavioral modification therapy as ordered
✘O c.) Addressing the client's low self-esteem
✘O d.) Regularly monitoring vital signs and weight

RATIONALE

RATIONALE: The client with anorexia nervosa is at risk for death from self-starvation. Therefore, initiating caloric and nutritional therapy takes highest priority. Behavioral modification (in which client privileges depend on weight gain) and psychoanalysis (which addresses the client's low self-esteem, guilt, anxiety, and feelings of hopelessness and depression) are important aspects of care but are secondary to stabilizing the client's physical condition. Monitoring vital signs and weight is important in evaluating nutritional therapy but doesn't take precedence over providing adequate caloric intake to ensure survival.
NURSING PROCESS STEP: Planning
CLIENT NEEDS CATEGORY: Physiological integrity
CLIENT NEEDS SUBCATEGORY: Reduction of risk potential
COGNITIVE LEVEL: Comprehension