A nurse is caring for a client who has depression. Which of the following noninvasive treatments should the nurse recommend to the client?

A. The ECG shows persistent sinus bradycardia on both December 1 and December 15. While sinus bradycardia is common in anorexia nervosa, its persistence may not necessarily reflect a therapeutic response.

B. The respiratory rate improved from 24/min to 20/min and the respirations are described as even and unlabored on December 15. This indicates a positive response to treatment.

C. The temperature data for December 15 is not provided. However, an increase toward normal temperature would indicate a therapeutic response, but without this data, we cannot confirm.

D. The weight increased from 34.5 kg (76 lb) to 37.2 kg (82 lb), which is a significant therapeutic improvement, reflecting progress in treatment.

E. The sodium level improved from 128 mEq/L to 130 mEq/L. Although the level is still slightly below normal, the upward trend indicates improvement.

F. The creatinine level decreased from 1.2 mg/dL to 0.9 mg/dL, showing improvement in kidney function and response to treatment.

Rationale:

A. Action involves actively making changes or implementing strategies to alter behavior. The client's refusal to follow dietary advice indicates they are not actively engaging in behavior change.

B. Preparation entails planning and getting ready to make a change. The client’s statement shows no intention of preparing for a change.

C. Contemplation involves recognizing the need for change and considering it but not yet committed to making it. The client’s dismissive attitude suggests they are not at this stage.

D. Precontemplation is characterized by a lack of awareness or denial of the need for change. The client’s indifference to the dietary recommendations reflects this stage, as they are not yet considering changing their behavior.