A nurse is caring for a client in an emergency department (ED).

Exhibits

For each assessment finding, click to specify if the finding is consistent with bulimia nervosa or anorexia nervosa. Each finding may support more than one disease process or none at all. There must be at least 1 selection In every column. There does not need to be a selection in every row. (Note: Each category must have at least 1 response option selected)

Rationale:

A. Keep objects in the client's room in the same place: Maintaining a consistent environment helps clients with vision loss navigate safely and confidently. Sudden changes in object placement can increase the risk of disorientation and injury.

B. Ensure there is high-wattage lighting in the client's room: While good lighting benefits clients with partial vision, high-wattage lighting can cause glare or discomfort. The focus should be on well-distributed, non-glare lighting suited to individual needs rather than universally high intensity.

C. Touch the client gently to announce presence: Gently touching a visually impaired client before speaking helps avoid startling them and fosters trust. It is a respectful way to make presence known when visual cues are unavailable.

D. Approach the client from the side: Approaching from the front is preferable so the client can better perceive the nurse's presence through remaining visual fields or auditory cues. Side approaches may lead to disorientation or surprise.

E. Allow extra time for the client to perform tasks: Clients with vision loss may require additional time to complete self-care or communication tasks. Rushing them can increase stress and compromise safety, so patience supports their independence.

Rationale:

A. Administer a dose of atomoxetine to decrease anxiety: Atomoxetine is a non-stimulant medication used primarily for ADHD, not for acute anxiety or panic attacks. It is not effective for treating panic symptoms and is not appropriate in this situation.

B. Sit with the client to provide a sense of security: Remaining with the client during a panic attack helps reduce fear, provides emotional support, and ensures safety. Calm presence and reassurance are essential to help the client regain a sense of control.

C. Encourage the client to watch television: Watching television requires attention and focus, which may be impaired during a panic attack. This suggestion does not address the immediate need for safety, calm, and emotional support.

D. Teach the client how to meditate: Teaching new coping techniques during a panic attack may be ineffective, as the client is overwhelmed and unable to concentrate. Such strategies are better introduced when the client is calm and receptive.