A nurse is assessing a patient with an eating disorder. Which of the following gastrointestinal symptoms would the nurse expect to find?

Choice A rationale:

Increased levels of cortisol and thyroid hormones. While stress-induced changes in cortisol levels can be seen in individuals with eating disorders, they are not the primary pathophysiological changes associated with these disorders. Cortisol plays a role in the body's response to stress and can contribute to weight gain, but altered levels of other hormones have a more direct impact on eating behaviors in individuals with eating disorders.

Choice B rationale:

Decreased levels of growth hormone and insulin. Growth hormone and insulin do play a role in metabolism and growth, but their levels are not commonly altered in eating disorders in the same way that hormones like leptin and ghrelin are. Altered levels of growth hormone and insulin can lead to metabolic disturbances, but these are not the hallmark changes seen in individuals with eating disorders.

Choice C rationale:

Altered levels of leptin and ghrelin. This is the correct choice. Leptin and ghrelin are two hormones that play a significant role in regulating hunger and satiety. Leptin, produced by adipose tissue, signals to the brain when energy stores are sufficient, thereby reducing appetite. Ghrelin, produced by the stomach, stimulates appetite and promotes food intake. In individuals with eating disorders, these hormones can become dysregulated, leading to disrupted hunger and fullness cues, and contributing to the development and maintenance of the disorder.

Choice D rationale:

Elevated levels of sex hormones and growth hormone. Elevated levels of sex hormones are not a primary pathophysiological change associated with eating disorders. Growth hormone, while important for growth and metabolism, is not a central player in the hormonal changes that drive eating disorder behaviors. Leptin and ghrelin are more directly involved in the dysregulation of eating behaviors seen in these disorders.

Choice A rationale:

This choice is inappropriate. In anorexia nervosa, encouraging the client to eat more may not address the underlying psychological and emotional issues related to the disorder. It oversimplifies the complexity of the disorder and could further exacerbate the client's anxiety about weight gain.

Choice B rationale:

This choice is inappropriate. Telling the client to stop restricting food intake oversimplifies the challenges of anorexia nervosa. Recovery involves addressing both the physical and psychological aspects of the disorder, and such a statement may not provide the necessary support and understanding.

Choice C rationale:

This choice is accurate. This statement acknowledges the client's fear of gaining weight while also emphasizing the importance of their health. It demonstrates empathy and understanding while promoting a balanced perspective on the client's concerns.

Choice D rationale:

This choice is inappropriate. Encouraging the client to exercise more as a way to increase appetite overlooks the fact that anorexia nervosa is not solely about appetite suppression. The disorder involves complex psychological factors that cannot be addressed through simple solutions like increased exercise.