A nurse is caring for a client with bulimia. The nurse recognizes which of the following would be a therapeutic intervention?

Arranging for individual therapy sessions

Encouraging the client to keep a food diary

Administering a medication to suppress the client's appetite

Scheduling daily weigh-ins for the client

Answer and Explanation

The Correct Answer is B

A. Arranging for individual therapy sessions: While individual therapy can be beneficial for clients with bulimia, it is not the sole intervention and typically part of a broader treatment plan. Therapy should focus on cognitive-behavioral strategies to address eating behaviors and underlying emotional issues.

B. Encouraging the client to keep a food diary: Keeping a food diary is a common therapeutic intervention for bulimia. It helps clients become more aware of their eating patterns and triggers for binge eating and purging behaviors. It also assists in identifying emotional and situational triggers that can be addressed in therapy.

C. Administering a medication to suppress the client's appetite: Appetite suppressants are not typically used in the treatment of bulimia. The focus is on addressing the underlying psychological issues and behaviors rather than suppressing appetite, as bulimia involves cycles of binge eating followed by compensatory behaviors like vomiting or laxative use.

D. Scheduling daily weigh-ins for the client: Daily weigh-ins can contribute to increased anxiety and obsession with weight, which may exacerbate bulimic behaviors. Therapeutic interventions for bulimia should focus on normalizing eating patterns and addressing the psychological aspects of the disorder rather than focusing on weight.

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Correct Answer is A

Explanation

A. The pharmacological action of Ritalin causes a decrease in appetite. Methylphenidate (Ritalin) is a stimulant medication commonly prescribed for ADHD. One of its well-documented side effects is appetite suppression, which can lead to weight loss. This is the most accurate and direct explanation for the weight loss observed in the adolescent client.

B. Side effects of Ritalin cause nausea; therefore, caloric intake is decreased. While nausea can occur with methylphenidate, it is not the primary reason for weight loss. The main mechanism is appetite suppression rather than a direct reduction in caloric intake due to nausea. This response is less accurate than option A.

C. Increased ability to concentrate allows the client to focus on activities rather than food: While methylphenidate can improve concentration, this explanation does not directly address the physiological cause of weight loss. It is the decrease in appetite due to the drug's effects on neurotransmitters that leads to weight loss, not the increased focus on activities .

D. Hyperactivity seen in ADHD causes increased caloric expenditure: Hyperactivity itself can lead to higher caloric expenditure, but this is not directly related to the weight loss caused by methylphenidate. The primary reason for the weight loss in this case is the appetite suppression due to the medication, not increased activity .

Correct Answer is []

Explanation

Potential Condition

Bulimia nervosa: The client has a BMI of 18.5, which is on the lower end of normal, indicating possible weight issues, but not the severe underweight typical of anorexia nervosa. The client describes cycles of binge eating followed by compensatory behaviors such as purging (using laxatives), which are characteristic of bulimia nervosa. The client expresses a preoccupation with food and body weight, and feelings of embarrassment about their eating habits, which align with bulimia nervosa.

Actions to Take

1. Assess binging and purging patterns: It's crucial to understand the frequency, triggers, and methods of binging and purging to tailor interventions effectively and to monitor the severity and progression of bulimia.

2. Encourage client to identify triggers for overeating: Identifying triggers for binging can help the client develop healthier coping mechanisms and reduce the occurrence of binge eating episodes.

Parameters to Monitor

1. Electrolyte levels: Frequent use of laxatives and purging behaviors can lead to electrolyte imbalances, which are potentially life-threatening and must be monitored regularly.

2. Frequency of compensatory behaviors: Tracking the frequency of purging behaviors (such as laxative use) helps assess the effectiveness of interventions and the client’s progress in reducing harmful behaviors.

Incorrect answers:

Actions to Take:

Assess for and discourage provocative or seductive behaviour: This is more relevant to histrionic personality disorder, not bulimia nervosa.
Weigh daily for the first week: While weighing the client can be part of the monitoring process, daily weigh-ins can increase anxiety and may not directly address the core issues of bulimia.
Assess for consumption of right food items: While dietary intake is important, focusing solely on food items without addressing the psychological aspects may not be effective for treating bulimia.

Parameters to Monitor:

Attention-seeking behaviours: More relevant to histrionic personality disorder than bulimia nervosa.
Signs of infection: Not directly relevant unless there is evidence of a related health issue or a compromised immune system, which is not indicated in the provided information.
Presence of lanugo: Lanugo is more commonly associated with anorexia nervosa due to severe malnutrition, not bulimia.

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A nurse is caring for a client with bulimia. The nurse recognizes which of the following would be a therapeutic intervention?

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Correct Answer is A

Explanation

Correct Answer is []

Explanation

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