A nurse is planning care for a client who reports increasing difficulty swallowing food. Which of the following interventions should the nurse plan to take?

A. Muscle weakness: Potassium is essential for normal neuromuscular function, and a low serum potassium level disrupts muscle cell excitability and contractility. As a result, clients may present with generalized weakness, particularly in the lower extremities, and may have difficulty with mobility or respiration if the weakness progresses.
B. Hyperreflexia: Hyperreflexia is more commonly associated with elevated calcium or magnesium imbalances rather than decreased potassium. Hypokalemia typically causes reduced neuromuscular excitability, which would result in diminished or absent reflexes rather than increased reflex activity. Therefore, hyperreflexia is not an expected finding in a client with low potassium.
C. Chvostek's sign: Chvostek’s sign is associated with hypocalcemia, not hypokalemia. It is elicited by tapping the facial nerve, resulting in twitching of the facial muscles. This sign indicates increased neuromuscular excitability due to low calcium levels, which is unrelated to potassium regulation. It is not expected in cases of decreased potassium.
D. Seizures: Seizures are more commonly linked with abnormalities in sodium or calcium levels, particularly hyponatremia or severe hypocalcemia. While severe hypokalemia can lead to cardiac arrhythmias and muscle paralysis, it is not typically associated with seizures. Therefore, seizures are not a standard finding in clients with hypokalemia.

A. Offer the client a selection of beverages at each meal: Providing a variety of beverages may offer hydration and a sense of control, but clients with anorexia nervosa often use fluids to avoid calorie-dense solid foods. This approach can reinforce avoidance behaviors and does not contribute meaningfully to nutritional rehabilitation or psychological recovery.
B. Inform the client that a weight gain of 2.3 kg (5 lb) per week is expected: A weight gain goal of 2.3 kg per week is too aggressive and may provoke anxiety or resistance from the client. A slower, more gradual goal of 0.5 to 1 kg (1 to 2 lb) per week is considered safer and more psychologically tolerable. Unrealistic expectations can harm rapport and may lead to nonadherence or relapse.
C. Arrange for someone to remain with the client for 30 min after meals: Monitoring after meals is essential to prevent purging or other compensatory behaviors. The standard is 60 to 90 minutes post-meal observation to address delayed attempts at purging or exercising. Thus, while well-intentioned, this time frame is insufficient.
D. Encourage the client to participate in developing dietary goals: Involving the client in setting dietary goals promotes a sense of autonomy, collaboration, and ownership in the recovery process. This approach is therapeutic, reduces power struggles, and helps build trust between the nurse and the client.