A nurse is preparing to administer amantadine 150 mg PO every 12 hr. The available medication is amantadine 50 mg/5 mL syrup.

How many mL should the nurse administer per dose?

Choice A rationale: Brittle and thin hair is a common physical manifestation of anorexia nervosa. This is due to malnutrition, which affects the health and quality of hair.

Choice B rationale: The presence of soft, unpigmented hair on the arms (and other parts of the body) is known as lanugo.

It’s a type of fine hair that the body produces in response to severe malnutrition, often seen in cases of anorexia nervosa.

The body grows lanugo in an attempt to provide insulation and maintain body heat, due to the loss of insulating body fat.

Choice C rationale: Individuals with anorexia nervosa typically have a distorted body image and often perceive themselves as overweight, even when they are underweight.

Therefore, it’s unlikely for them to comment that they are too thin and need to gain weight.

Choice D rationale: Preoccupation with thoughts about food is a common psychological symptom of anorexia nervosa. Individuals with this disorder often spend a lot of time thinking about food, dieting, and body weight.

Choice E rationale: Feeling “too tired” and lacking interest in daily workouts can be a result of the physical exhaustion and weakness caused by severe calorie restriction and malnutrition in anorexia nervosa.

Choice F rationale: The client’s report of consuming around 600 calories per day is not provided in the question. Therefore, it cannot be evaluated.

In conclusion, the nurse should expect to find brittle and thin hair, soft unpigmented hair on the arms, preoccupation with thoughts about food, and lack of energy or interest in daily activities in a client with anorexia nervosa.

Choice A: Limit the amount of time available to interact with others

While the client's behavior may indirectly limit their interactions with others by occupying their time, this is not the primary function of their actions. The core motivation lies in reducing anxiety, not social avoidance.

Choice B: Manipulate and control others' behaviors

Although the client's cleaning may influence others to tidy up, this is not a deliberate attempt to control their behavior. The primary drive stems from the client's internal need for order and cleanliness, not a desire to dictate the actions of others.

Choice C: Focus attention on meaningful tasks

While the act of cleaning can be productive and contribute to a pleasant environment, it's not the primary function or intention behind the client's behavior. Their actions are primarily driven by the need to quell anxiety, not necessarily to accomplish meaningful tasks.

Choice D: Decrease anxiety to a tolerable level

This is the most accurate rationale for the client's behavior. Individuals with OCD engage in compulsions, like excessive cleaning, to alleviate the intense anxiety associated with their intrusive thoughts and obsessions. In this case, the act of picking up after others provides the client with a sense of order and control, thereby reducing their anxiety to a manageable level.

Elaboration:

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). Individuals with OCD experience significant anxiety due to their obsessions and feel compelled to engage in compulsions to manage that anxiety.

In the scenario presented, the client's constant cleaning behavior likely stems from an obsession with order and cleanliness. This obsession triggers anxiety when the environment is perceived as messy or disorderly. The act of picking up after others serves as a compulsion, a ritualistic behavior performed to reduce the anxiety caused by the obsession. By restoring order and cleanliness, the client temporarily alleviates their anxiety and achieves a sense of control over their environment.

It's important to recognize that the client's cleaning behavior, while seemingly productive, is primarily driven by their internal need to manage anxiety, not by a genuine desire to help others or maintain a tidy environment. This understanding is crucial for the nurse to effectively support the client and guide them towards healthier coping mechanisms for managing their OCD symptoms.