A nurse is evaluating the effectiveness of the nursing interventions for a patient with an eating disorder. Which of the following actions should the nurse take?

Choice A rationale:

Bradycardia and tachycardia. While these cardiovascular symptoms can occur in eating disorders, they are more commonly associated with anorexia nervosa rather than bulimia nervosa. Bradycardia (slow heart rate) is often seen in individuals with severe anorexia due to the body's adaptive response to conserve energy. Tachycardia (rapid heart rate) can occur as a compensatory mechanism in response to dehydration and electrolyte imbalances, particularly in those with anorexia. However, in bulimia nervosa, the rapid cycle of binge eating and purging is more likely to lead to electrolyte imbalances that cause other symptoms.

Choice B rationale:

Hypertension and mitral valve prolapse. Hypertension (high blood pressure) is not a common cardiovascular symptom of bulimia nervosa. Mitral valve prolapse, which involves the improper closing of the heart's mitral valve, is also not a typical cardiovascular manifestation of bulimia nervosa. Eating disorders primarily affect the electrical conduction system of the heart and can lead to rhythm disturbances.

Choice C rationale:

Orthostatic hypotension and arrhythmias. This is the correct choice. Orthostatic hypotension, which is a drop in blood pressure upon standing, is a common cardiovascular symptom of bulimia nervosa. It is often a result of dehydration and electrolyte imbalances caused by frequent vomiting and laxative use. Arrhythmias (irregular heart rhythms) can also occur due to electrolyte imbalances, particularly low levels of potassium, which can disrupt the heart's electrical activity.

Choice D rationale:

Pericardial effusion and cardiomyopathy. While pericardial effusion (accumulation of fluid around the heart) and cardiomyopathy (disease of the heart muscle) can occur in individuals with eating disorders, they are not the most common cardiovascular symptoms. These conditions usually result from prolonged malnutrition and severe electrolyte imbalances, which can occur in both anorexia nervosa and bulimia nervosa. However, orthostatic hypotension and arrhythmias are more characteristic of bulimia nervosa.

Choice A rationale:

Ignoring the client's beliefs to avoid escalating distress is not a therapeutic approach. Addressing cognitive distortions and irrational beliefs is crucial in helping the client reframe their thoughts and promote healthier behaviors.

Choice B rationale:

Encouraging the client to engage in self-isolation is counterproductive. Isolation can worsen the client's condition and hinder their recovery.

Choice C rationale:

Addressing cognitive distortions and irrational beliefs is the appropriate therapeutic approach. This involves working with the client to identify and challenge negative thought patterns, helping them develop a more realistic perception of their body image and self-worth.

Choice D rationale:

Avoiding discussing body image to prevent embarrassment is not effective. Open and sensitive discussions about body image are important in the therapeutic process to help the client gain insight into their feelings and beliefs.