A nurse in an outpatient mental health clinic is treating a client who has bulimia nervosa.
A nurse is assessing the client during a follow-up visit. Select the 4 assessments that indicate a therapeutic response to the treatment plan.
Potassium level
ECG report
BUN level
Laxative usage
overeating cycle/purging
Coping skills
Correct Answer : A,D,E,F
Choice A: Potassium Level
Reason: Monitoring potassium levels is crucial in clients with bulimia nervosa due to the risk of hypokalemia (low potassium levels), which can result from frequent vomiting and laxative abuse. Hypokalemia can lead to serious complications, including cardiac arrhythmias. In this case, the client’s potassium level improved from 3.2 mEq/L (below the normal range of 3.5 to 5 mEq/L) on June 1 to 3.7 mEq/L (within the normal range) on June 15. This improvement indicates a positive response to treatment, as it suggests that the client is experiencing fewer episodes of vomiting or laxative abuse, leading to better electrolyte balance.
Choice B: ECG Report
Reason: While the ECG report is important for assessing cardiac health, it is not a direct indicator of therapeutic response to bulimia nervosa treatment. The presence of premature ventricular contractions (PVCs) on the ECG can be related to electrolyte imbalances, particularly hypokalemia. However, the ECG itself does not provide information about the client’s behaviors or coping mechanisms, which are more directly related to the treatment of bulimia
nervosa. Therefore, while the ECG report is useful for monitoring cardiac health, it is not one of the primary indicators of therapeutic response in this context.
Choice C: BUN Level
Reason: Blood Urea Nitrogen (BUN) levels can indicate kidney function and hydration status. Elevated BUN levels, as seen in this client (28 mg/dL on June 1 and 26 mg/dL on June 15, with a normal range of 10 to 20 mg/dL), may suggest dehydration or impaired kidney function. However, BUN levels are not specific indicators of therapeutic
response to bulimia nervosa treatment. They do not directly reflect changes in the client’s eating behaviors, purging habits, or coping skills. Therefore, while monitoring BUN levels is important for overall health, it is not a primary indicator of therapeutic response in this case.
Choice D: Laxative Usage
Reason: Reducing or eliminating laxative usage is a significant indicator of therapeutic response in clients with bulimia nervosa. Laxative abuse is a common purging behavior in bulimia nervosa, and its reduction indicates progress in treatment. The client’s report of laxative usage provides direct insight into their purging behaviors. A
decrease in laxative use suggests that the client is gaining better control over their eating disorder and is adhering to the treatment plan. This behavioral change is a critical component of recovery and indicates a positive therapeutic response.
Choice E: Overeating Cycle/Purging
Reason: Assessing changes in the client’s overeating and purging cycle is essential for evaluating therapeutic response. Bulimia nervosa is characterized by cycles of binge eating followed by purging behaviors such as vomiting or laxative abuse. A reduction in the frequency or severity of these cycles indicates that the client is responding well to treatment. The client’s self-reported behaviors regarding overeating and purging provide valuable information about their progress. A decrease in these behaviors suggests that the client is developing healthier eating patterns and coping mechanisms, which are key goals of treatment.
Choice F: Coping Skills
Reason: Developing effective coping skills is a crucial aspect of treatment for bulimia nervosa. Clients often use disordered eating behaviors as a way to cope with emotional distress. By learning and implementing healthier coping strategies, clients can reduce their reliance on harmful behaviors such as binge eating and purging. Assessing the client’s coping skills involves evaluating their ability to manage stress, emotions, and triggers in a healthy manner. Improvement in coping skills indicates that the client is making progress in their recovery and is better equipped to handle challenges without resorting to disordered eating behaviors.
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Related Questions
Correct Answer is C
Explanation
Choice A reason:
The statement that nonverbal communication conveys less truth than what the client states verbally is incorrect. Nonverbal communication often conveys more truth than verbal communication because it includes body language, facial expressions, and other cues that can reveal a person’s true feelings and intentions. People may say one thing but their nonverbal cues can indicate something different.
Choice B reason:
The statement that the client enacts nonverbal communication consciously is not entirely accurate. While some nonverbal behaviors are conscious, many are subconscious and automatic. For example, facial expressions and body posture often occur without conscious thought and can provide genuine insights into a person’s emotions and state of mind.
Choice C reason:
The client’s sociocultural background influences nonverbal communication is correct. Different cultures have varying norms and interpretations for nonverbal behaviors. For instance, eye contact, gestures, and personal space can have different meanings across cultures. Understanding a client’s sociocultural background helps in accurately interpreting their nonverbal cues.
Choice D reason:
The statement that nonverbal communication is a poor reflection of what the client feels is incorrect. Nonverbal communication is often a very accurate reflection of a person’s feelings. It includes subtle cues like tone of voice, facial expressions, and body language, which can provide deeper insights into a person’s emotional state than words alone.
Correct Answer is A
Explanation
Choice A reason: Eating a snack half an hour before playing soccer is a good practice for children with type 1 diabetes. Physical activity can lower blood glucose levels, and having a snack beforehand helps prevent hypoglycemia. This statement indicates that the child understands the importance of managing blood glucose levels during exercise.
Choice B reason: My morning blood glucose should be between 90 and 130 is a correct statement regarding target blood glucose levels for children with type 1 diabetes. However, this statement alone does not indicate a comprehensive understanding of diabetes management, as it only addresses one aspect of blood glucose monitoring.
Choice C reason: I should not take my regular insulin when I am sick is incorrect. Children with type 1 diabetes should continue taking their insulin even when they are sick, as illness can cause blood glucose levels to rise. They may need to adjust their insulin dosage, but stopping insulin altogether can lead to dangerous complications like diabetic ketoacidosis.
Choice D reason: I can store unopened bottles of insulin in the freezer is incorrect. Insulin should be stored in the refrigerator, not the freezer. Freezing insulin can damage its effectiveness. Unopened insulin should be kept at a temperature between 36°F and 46°F (2°C to 8°C).
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