The nurse is admitting a client with malnutrition related to anorexia nervosa. Which of the following actions are appropriate to include in the care of this client? Select all that apply.

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11ecbb05_cc3c_318d_b433_9dfa444d9067_MD0009_00 Anorexia nervosa is a psychogenic eating disorder with potentially fatal physiological implications. Clients commonly become extremely underweight and protein-energy malnourished. Clients admitted for anorexia nervosa are typically in a crisis state, and the priority is restoring physiological integrity through appropriate weight gain and nutritional intake. Nursing care includes: Assisting the client in reflecting on triggers for dysfunctional eating and fears and feelings related to gaining weight (Option B) Maintaining strict documentation of dietary protein and calorie intake to ensure healthy weight gain (Option C) Remaining with the client during and 1 hour following meals to ensure intake and prevent purging behaviors (Option D) Establishing a weekly weight-gain goal (typically 2-3 lb/wk [0.91-1.36 kg/wk]) Weighing the client at the same time each morning (after voiding and before any oral intake) and wearing the same clothing to assess efficacy of nutritional support (Option E) Limiting physical activity initially and gradually increasing as oral intake improves Not focusing on food initially, but encouraging participation in meal planning as the client nears target weight (Option A) Clients admitted with anorexia nervosa should not continue to exercise, because this would cause further energy deficit and worsen malnutrition and end-organ damage (eg, renal failure). Educational objective: Clients admitted with anorexia nervosa must increase caloric intake and stop exercising to promote weight gain. The nurse should record consumed calories, weigh the client daily, remain with the client during and for 1 hour following meals, and encourage discussion about dysfunctional eating triggers.

The Nurse Is Admitting a Client with Malnutrition Related to Anorexia