A mental health nurse on an inpatient eating disorders unit is caring for a client who has anorexia nervosa and has a body mass index of 16.7. Which of the following actions should the nurse take? (Select all that apply.)
A.
Monitor the client’s weight daily
B.
Allow the client to choose the meals she will eat
C.
Allow the client to practice strenuous exercises
D.
Stay with the client during meals and for 2 hrs after meals
E.
Provide the client with small meals frequently.
The Correct Answer and Explanation is:
For a client with anorexia nervosa and a body mass index (BMI) of 16.7, the appropriate nursing actions include:
A. Monitor the client’s weight daily
D. Stay with the client during meals and for 2 hours after meals
E. Provide the client with small meals frequently
Here’s a detailed explanation for each of these actions:
A. Monitor the client’s weight daily: Regular monitoring of the client’s weight is crucial for assessing their nutritional status and progress. Anorexia nervosa is characterized by significant weight loss and malnutrition, and daily weight checks help track changes in weight, guide treatment adjustments, and ensure the client is not engaging in behaviors to manipulate the results (e.g., excessive exercise or purging).
D. Stay with the client during meals and for 2 hours after meals: Clients with anorexia nervosa often engage in purging or restrictive behaviors around meal times. Staying with the client during and after meals helps prevent these behaviors and ensures that the client is consuming their meals without interference. This practice also helps provide support and monitoring for any adverse reactions to food intake, which can be a concern in this population.
E. Provide the client with small meals frequently: Smaller, more frequent meals are generally better tolerated by clients with anorexia nervosa than larger, less frequent meals. This approach can help prevent overwhelming the client and promote gradual weight gain. Frequent meals also help maintain stable blood sugar levels and can be easier for the client to manage psychologically compared to larger meal portions.
Why the other options are less appropriate:
B. Allow the client to choose the meals she will eat: While offering some choice can be supportive, clients with anorexia nervosa may use this opportunity to select low-calorie or non-nutritious options. This can hinder their recovery process, so meal planning is often more effective when managed by the healthcare team.
C. Allow the client to practice strenuous exercises: Strenuous exercise is contraindicated in clients with anorexia nervosa due to the risk of exacerbating malnutrition and causing further health complications. Exercise should be carefully monitored and generally limited until the client has achieved a more stable weight and nutritional status.
In summary, the selected actions focus on providing safe, supportive care that addresses both the physical and psychological aspects of anorexia nervosa.