After 3 weeks, you are providing discharge teaching for J.M. you ask her whether she is ready to go home. J.M. states, "I'll be so glad to get out of this place. I'm so fat and ugly
I need to lose 10 pounds. I bet I can
do it in just a couple of days. Otherwise, I don't want to live anymore."
What will you discuss with the physician before any further discharge teaching or plans?
You report J.M.'s statements to the physician. What actions do you expect the physician to take?
What medications would be indicated for J.M. to assist with resolution of both her anorexia
nervosa and her depression?
Which statements by J.M. would indicate successful treatment? Select all that apply.
a. "When you say I look 'healthy' I feel fat."
b. "Lately I've been feeling a little better about things."
c. "It's up to me to take care of my body by eating enough food."
d. "I just have to stay skinny to feel good."
e. "I am looking forward to going out with my friends again."
• J.M. is possibly depressed and suicidal.
• J.M. hasn't made any internal psychological changes.
• J.M. hasn't gained any insight into the seriousness of her illness.
• J.M. might relapse and is at risk for losing some or all of the weight she has gained.
• J.M. is at risk for further ECG changes; electrolyte imbalances; and complete blood count,
endocrine, and urinalysis abnormalities.
• J.M. is at risk for chronic anorexia nervosa.
• J.M. might be at risk for an early death.
• She will not be discharged until the depression lessens.
• She will be placed on suicide precautions.
• She might be placed on an antidepressant or other medication.
There are no drugs approved for the treatment of anorexia nervosa. Selective serotonin reuptake
inhibitors (SSRIs) may be used to elevate her depressed mood and can stimulate her appetite. If
she is experiencing high levels of anxiety, anxiolytics, such as benzodiazepines, may be ordered for
short-term use. Some patients might benefit from atypical antipsychotic drugs, such as olanzapine
(Zyprexa), for improving mood and decreasing resistance to weight gain.
Answers: b, c, e
You might also like to view...
A young woman asks the nurse about breast augmentation surgery. An appropriate response by the nurse would be:
1. "It is a very common surgery, and the technique has been perfected." 2. "There is no evidence of implants causing cancer, but the implants do make detection of cancer more difficult." 3. "It has been proven that women who have breast augmentation are at greater risk for breast cancer." 4. "You might want to think about it, because the scar tissue distorts the breasts."
The student nurse is preparing an educational project for a women's senior citizen organization on heart disease. What information needs to be included?
A) Signs and symptoms of heart disease that are the same in men and women B) Symptoms of heart disease in older women may include sleep disturbances, nausea, vomiting, and discomfort in the neck, back, or jaw. C) Women who are having a heart attack seek medical treatment earlier than men D) Exercise stress tests are more accurate in women
A woman is 16 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. The best answer is
a. "You should have felt the baby move by now." b. "Within the next month, you should start to feel fluttering sensations." c. "The baby is moving, but you can't feel it yet." d. "Some babies are quiet, and you don't feel them move."
What do government standards require about using chemical and physical restraints in long-term care?
1. Use nonprescription restraints first. 2. Obtain with a telephone prescription. 3. Implement alternative measures first. 4. Notify client's family within 24 hours.