A nurse is planning care for a client who has anorexia nervosa. Which of the following actions should the nurse include in the plan?
Offer the client a selection of beverages at each meal.
Inform the client that a weight gain of 2.3 kg (5 lb) per week is expected.
Arrange for someone to remain with the client for 30 min after meals.
Encourage the client to participate in developing dietary goals.
The Correct Answer is D
Choice A reason: Offering the client a selection of beverages at each meal is not a good action to include in the plan, as it may reduce the client's appetite and intake of solid foods. The nurse should limit the client's fluid intake before and during meals, and encourage the client to consume high-calorie and high-protein drinks, such as milkshakes or smoothies, after meals.
Choice B reason: Informing the client that a weight gain of 2.3 kg (5 lb) per week is expected is not a good action to include in the plan, as it may cause anxiety and resistance in the client. The nurse should set realistic and individualized weight goals for the client, and monitor the client's weight and vital signs regularly. The nurse should also avoid focusing on the client's weight, and instead emphasize the client's health and well-being.
Choice C reason: Arranging for someone to remain with the client for 30 min after meals is a good action to include in the plan, as it can prevent the client from purging or exercising excessively. The nurse should provide a supportive and nonjudgmental environment for the client, and supervise the client's eating and toileting behaviors. The nurse should also educate the client and the family about the complications and treatment of anorexia nervosa.
Choice D reason: Encouraging the client to participate in developing dietary goals is a good action to include in the plan, as it can increase the client's sense of control and motivation. The nurse should collaborate with the client, the dietitian, and the mental health team to create a personalized and flexible meal plan that meets the client's nutritional and psychological needs. The nurse should also praise the client for any progress or achievement, and reinforce the client's positive coping skills.
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Related Questions
Correct Answer is D
Explanation
Choice A reason: Increased cholesterol is not an indication that the weight loss program has been effective, as it is a risk factor for cardiovascular disease and stroke. The nurse should expect the client's cholesterol level to decrease as a result of the weight loss program, as it can lower the production and absorption of cholesterol in the body.
Choice B reason: Increased glycosylated hemoglobin (HbA1c) is not an indication that the weight loss program has been effective, as it is a measure of the average blood glucose level over the past 2 to 3 months. The nurse should expect the client's HbA1c level to decrease as a result of the weight loss program, as it can improve the insulin sensitivity and glucose metabolism of the body.
Choice C reason: Increased LDL (low-density lipoprotein) is not an indication that the weight loss program has been effective, as it is the "bad" cholesterol that can accumulate in the arteries and cause atherosclerosis. The nurse should expect the client's LDL level to decrease as a result of the weight loss program, as it can reduce the synthesis and secretion of LDL in the liver.
Choice D reason: Increased HDL (high-density lipoprotein) is an indication that the weight loss program has been effective, as it is the "good" cholesterol that can remove excess cholesterol from the blood and transport it to the liver for excretion. The nurse should expect the client's HDL level to increase as a result of the weight loss program, as it can enhance the activity and expression of HDL in the body.
Correct Answer is D
Explanation
Choice A reason: Green tea is not a beverage that enhances the absorption of nonheme iron, but rather inhibits it. Green tea contains tannins, which are compounds that bind to iron and prevent its absorption. The nurse should advise the client to avoid drinking green tea or other beverages that contain tannins, such as black tea, with meals that contain iron.
Choice B reason: Coffee is not a beverage that enhances the absorption of nonheme iron, but rather inhibits it. Coffee also contains tannins, as well as caffeine, which can interfere with iron absorption. The nurse should recommend the client to limit or avoid coffee intake, especially with iron-rich foods.
Choice C reason: Milk is not a beverage that enhances the absorption of nonheme iron, but rather inhibits it. Milk contains calcium, which can compete with iron for absorption. The nurse should suggest the client to consume milk and other dairy products separately from iron-containing foods.
Choice D reason: Orange juice is a beverage that enhances the absorption of nonheme iron, as it is rich in vitamin C. Vitamin C can increase the absorption of nonheme iron by converting it from the ferric form to the more absorbable ferrous form. The nurse should encourage the client to drink orange juice or other citrus juices with meals that contain iron.
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