A nursing care plan for a patient with anorexia nervosa includes the intervention “monitor for complications of refeed. “Which system should a registered nurse closely monitor for dysfunction?
Select one:
A.
Endocrine
B.
Respiratory
C.
Musculoskeletal
D.
Cardiovascular
The correct answer and Explanation is:
The correct answer is D. Cardiovascular.
Explanation:
When initiating refeeding therapy in patients with anorexia nervosa, it is crucial to monitor the cardiovascular system closely. This is because refeeding carries the risk of several potential complications, most notably refeeding syndrome. Refeeding syndrome is a dangerous condition that can occur when feeding is resumed in a patient who is malnourished, especially if it is done too rapidly.
Refeeding syndrome is characterized by a range of metabolic disturbances that can profoundly affect the cardiovascular system. The most critical issues arise from imbalances in electrolytes, particularly phosphate, potassium, and magnesium. These electrolytes are crucial for normal cardiac function and muscle contraction. An imbalance can lead to:
- Arrhythmias: Abnormal heart rhythms can develop due to electrolyte imbalances, particularly hypokalemia (low potassium) and hypomagnesemia (low magnesium). These arrhythmias can be life-threatening and require immediate attention.
- Heart Failure: Severe electrolyte imbalances and fluid shifts can put extra stress on the heart, potentially leading to heart failure or exacerbating pre-existing cardiac conditions.
- Hypotension: Sudden changes in fluid status and electrolyte imbalances can cause a drop in blood pressure, leading to hypotension, which can result in dizziness, fainting, and even shock if severe.
Monitoring the cardiovascular system involves regular checks of vital signs, including heart rate and blood pressure, as well as continuous ECG monitoring if indicated. Additionally, electrolytes should be closely monitored through laboratory tests to detect and correct imbalances early.
While complications related to the endocrine, respiratory, or musculoskeletal systems can occur, the immediate and severe risks associated with refeeding syndrome predominantly impact the cardiovascular system. Therefore, it is paramount for healthcare providers to maintain vigilant cardiovascular monitoring during the refeeding process to ensure patient safety and respond promptly to any complications that arise.