A 17-year-old girl comes to the health department clinic to renew her oral contraceptive pills.During the physical examination,the nurse observes that the girl has broken blood vessels on her face and her lips are cracked and chapped and her fingers are callused.What further actions will the nurse perform? (Select all that apply.)

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Bulimia nervosa is a syndrome that consists of a cycle of binge eating and purging.Physically,the adolescent with bulimia nervosa may exhibit physical changes related to forced,excessive vomiting: cracked and damaged lips,tooth damage,callused fingers and hands,and broken blood vessels in the face.Other findings that may not be readily apparent include throat irritation,esophageal inflammation,and parotitis from vomiting,as well as rectal bleeding from overuse of laxatives.Bulimia is also associated with depression.The nurse should assess the teen's weight,screen her for depression,draw blood for electrolyte imbalances,and discuss bulimia.

A 17-Year-Old Girl Comes to the Health Department Clinic to Renew