A patient referred to the eating disorders clinic has lost 35 ...

[Yi-Chen]

A patient referred to the eating disorders clinic has lost 35 pounds in 3 months and has developed amenorrhea. For which physical manifestations of anorexia nervosa should a nurse assess? Select all that apply.
 
  a. Peripheral edema
  b. Parotid swelling
  c. Constipation
  d. Hypotension
  e. Dental caries
  f. Lanugo

Question 2

A patient became severely depressed when the last of six children moved out of the home 4 months ago. The patient repeatedly says, No one cares about me. I'm not worth anything. Which response by the nurse would be the most helpful?
 
  a. Things will look brighter soon. Everyone feels down once in a while.
  b. The staff here cares about you and wants to try to help you get better.
  c. It is difficult for others to care about you when you repeatedly say the same negative things.
  d. I'll sit with you for 10 minutes now and return for 10 minutes at lunchtime and again at 2:30 this afternoon.

[shaquita]

Answer to Question 1

ANS: A, C, D, F
Peripheral edema is often present because of hypoalbuminemia. Constipation related to starvation is often present. Hypotension is often present because of dehydration. Lanugo is often present and is related to starvation. Parotid swelling is associated with bulimia. Dental caries are associated with bulimia.

Answer to Question 2

ANS: D
Spending time with the patient at intervals throughout the day shows acceptance by the nurse and helps the patient establish a relationship with the nurse. The therapeutic technique is called offering self. Setting definite times for the therapeutic contacts and keeping the appointments show predictability on the part of the nurse, an element that fosters the building of trust. The incorrect responses would be difficult for a person with profound depression to believe, provide trite reassurance, and are counterproductive. The patient is unable to say positive things at this point.