A nurse is creating a plan of care for a client who has anorexia nervosa. Which of the following interventions should the nurse include in the plan?

Prepare the client for electroconvulsive therapy.

Weigh the client twice per day.

Encourage the client to participate in family therapy.

Set a weight gain goal of 2.2 kg (4.9 lb) per week.

Answer and Explanation

The Correct Answer is C

A. Prepare the client for electroconvulsive therapy:
Electroconvulsive therapy (ECT) is not a standard or appropriate treatment for anorexia nervosa. ECT is primarily used for severe depression, bipolar disorder, and certain other mental health conditions. Anorexia nervosa is typically managed through psychotherapy, nutritional counseling, and medical monitoring, often in an outpatient or inpatient setting, depending on the severity of the disorder.

B. Weigh the client twice per day:
Frequent weighing is generally discouraged in the treatment of anorexia nervosa. Individuals with this disorder often have an unhealthy fixation on their weight. Frequent weigh-ins can exacerbate anxiety, foster an unhealthy relationship with food and body image, and reinforce obsessive thoughts about weight and appearance. Healthcare providers should monitor weight and nutritional status regularly, but the frequency should be determined based on the individual's specific needs and in a manner that does not worsen their anxiety.

C. Encourage the client to participate in family therapy:
This is the appropriate choice. Family therapy is often a crucial component of the treatment plan for anorexia nervosa. It helps address family dynamics, communication patterns, and any dysfunctional relationships that might contribute to the eating disorder. Family therapy provides a supportive environment for both the individual with anorexia and their family members, aiding in understanding, coping, and healing.

D. Set a weight gain goal of 2.2 kg (4.9 lb) per week:
Setting specific weight gain goals can be counterproductive and potentially harmful for individuals with anorexia nervosa. Rapid or arbitrary weight gain goals may lead to unhealthy eating behaviors, excessive exercise, or other dangerous practices in an attempt to meet the goal quickly. Instead, healthcare providers focus on a more individualized and gradual approach to weight restoration, ensuring that it is safe, sustainable, and in line with the client's overall health and well-being.

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Correct Answer is B

Explanation

A. A family member of the client:
Using a family member might seem like a natural choice, but it could lead to issues of confidentiality, especially if the client does not want their family to know about their situation. Moreover, there could be bias or hesitancy to discuss certain matters in the presence of a family member.

B. A translator of the same gender as the client:
This choice is ideal because individuals might feel more comfortable discussing personal and sensitive topics with someone of the same gender due to cultural or personal reasons. This can foster trust and open communication, crucial in support groups addressing sensitive matters like substance use disorders.

C. A unit secretary who speaks the same language as the client:
While this person might be fluent in the language, their role as a unit secretary might create discomfort for the client. They may not feel as at ease discussing personal issues with someone in a different professional role, even if they share the same language.

D. Another client who speaks the same language as the client:
While peer support can be beneficial, using another client as a translator can compromise the confidentiality and professionalism of the support group. It’s important to maintain boundaries and ensure that communication is facilitated by a professional translator or staff member, especially in sensitive and confidential settings like therapy or support groups.

A. Recommend that the client participate in more solitary activities. B. Explain to the client that the duration of grief is highly variable and can last for years. C. Encourage the client to avoid discussing the events surrounding the sibling's death. D. Caution the client against feeling angry at the sibling.

Correct Answer is B

Explanation

A. Recommend that the client participate in more solitary activities.
This option is not suitable because encouraging solitary activities may lead to further isolation, which can worsen the client's depressive feelings. Social support and connection are often crucial during the grieving process.

B. Explain to the client that the duration of grief is highly variable and can last for years.
This is the correct choice. Grief is a complex and individual process, and there is no specific timeline for how long it should last. Some people may continue to experience feelings of sadness and loss for an extended period after the death of a loved one. Validating the client's emotions and letting them know that their experience is within the range of normal can be comforting.

C. Encourage the client to avoid discussing the events surrounding the sibling's death.
This option is not recommended. Encouraging the client to avoid discussing their feelings can hinder the healing process. Open communication about the loss can help the client process their emotions and find ways to cope.

D. Caution the client against feeling angry at the sibling.
This option is not appropriate. Allowing the client to express their feelings, including anger, is a healthy part of the grieving process. Suppressing emotions, including anger, can lead to complications in the grieving process. It is essential to acknowledge and validate all the client's emotions.

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