Question

A nurse is caring for a client who has anorexia nervosa.

Vital Signs
Day 1:Blood pressure 90/60 mm HgHeart rate 54/minRespiratory rate 16/minTemperature 36.1° C (97° F)
Day 14:Blood pressure 88/58 mm HgHeart rate 64/minRespiratory rate 16/minTemperature 36.1° C (97° F)​
Diagnostic Results
Day 1:Potassium 3.2 mEq/L (3.5 to 5.0 mEq/L) Sodium 150 mEq/L (136 to 145 mEq/L) BUN 35 mg/dL (10 to 20 mg/dL) Glucose 78 mg/dL (74 to 106 mg/dL)
Day 14:Potassium 3.7 mEq/L (3.5 to 5.0 mEq/L) Sodium 143 mEq/L (136 to 145 mEq/L) BUN 18 mg/dL (10 to 20 mg/dL) Glucose 76 mg/dL (74 to 106 mg/dL)
Physical Examination
Day 1:• BMI 16.8 • Yellow sclera • Skin is cool • Reports no bowel movement for 5 days • 1+ peripheral edema • Reports exercising 2 hr per day
Day 14:• BMI 17.8 • Yellow sclera • Skin is warm • Reports last bowel movement 1 day ago • 1+ peripheral edema • Reports exercising 2 hr per day



A nurse is evaluating the client after 2 weeks. Which of the following findings indicate an improvement in the client's condition? (Select all that apply.)
a) BMI increase
b) Skin temperature decrease
c) BUN decrease
d) Bowel movement reported
e) Sodium decrease
f) Glucose decrease
g) Peripheral edema decrease
h) Blood pressure increase
i) Heart rate increase
j) Potassium increase

Answer 1

The findings that indicate improvement in the client's condition are an increase in BMI, a decrease in BUN within the normal range, a reported bowel movement after previously not having one for 5 days, sodium level normalization, an increase in heart rate closer to the normal range, and an increase in potassium to within the normal range.

Step-by-step explanation:

The question is asking to identify which findings suggest improvement in a client with anorexia nervosa after 14 days of care. Let's examine the findings that indicate improvement:

• BMI increase from 16.8 to 17.8 indicates weight gain, which is positive for anorexia recovery.
• BUN decrease from 35 mg/dL to 18 mg/dL falls within the normal range, reflecting improved renal function and overall health.
• Bowel movement reported one day ago compared to no bowel movement for 5 days is a sign of improvement in gastrointestinal function.
• Sodium decrease to 143 mEq/L, which is within the normal range, suggests an improvement in electrolyte balance.
• Heart rate increase from 54/min to 64/min, which is closer to the normal range, indicates better cardiovascular function.
• Potassium increase to 3.7 mEq/L from 3.2 mEq/L, reaching within the normal range, shows improved electrolyte balance.

None of the other options, such as skin temperature decrease, peripheral edema decrease, blood pressure increase, or glucose decrease, are supported by the data given. To summarize, the signs that indicate improvement in the client are the increase in BMI, normalization of BUN, reporting of a bowel movement, normalization of sodium, increase in heart rate, and increase in potassium levels.