Question

Nurse's Notes

The client reports a history of anxiety; diagnosed with Alzheimer's disease 2 months ago. The client's partner died 6 months ago. Reports decreased appetite, low energy levels, and insomnia for several weeks; some memory loss.
Graphic Results
SaO2 96% on room air
Respiratory rate 20/min
Blood pressure 112/76 mm Hg (lying)
Blood pressure 104/68 mm Hg (standing)
Heart rate 68/min
Temperature 36° C (96.8° F)
Medication Administration Record
Captopril 12.5 mg by mouth three times daily
Digoxin 0.125 mg by mouth each morning
Multivitamin with iron one by mouth daily
Docusate sodium 50 mg by mouth each evening
A nurse is updating the plan of care for a client who has bulimia nervosa and is 5% above their ideal body weight. Which of the following interventions should the nurse include in the plan?
A) Use a screening tool to evaluate the client for depression.
B) Ask the provider to decrease the dosage of the client's blood pressure medication.
C) Instruct the client to decrease intake of vitamin B12.
D) Suggest the client go for a brisk walk 20 min just before bedtime.

Answer 1

For a client with bulimia nervosa, the nursing plan should include using a screening tool for depression. Other options, such as adjusting blood pressure medication, reducing vitamin B12, or brisk walking before bedtime, are not appropriate without further clinical justification.

Step-by-step explanation:

A nursing intervention plan for a client with bulimia nervosa who is at 5% above ideal body weight should indeed include using a screening tool to evaluate for depression. Considering the client's history of anxiety and recent Alzheimer's diagnosis, along with the loss of a partner and symptoms of decreased appetite, low energy, and insomnia, these are potential indicators of depression, which is common in individuals with eating disorders.

The nurse should not suggest decreasing the dosage of the client's blood pressure medication without foundational evidence and the direction of a physician. Instructing the client to decrease vitamin B12 intake is also not a priority, as this nutrient is not directly linked to the treatment of bulimia nervosa. Advising vigorous activity before bedtime, like a brisk walk, is not advisable as it may hinder sleep rather than promote it.