A 16-years old girl is suffering from anorexia nervosa. Which one is a best nursing intervention for her?

NORCET 3 - 2022 (Shift-1)

Mental Health Nursing

Hard

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

The most critical priority in the acute care of anorexia nervosa is ensuring nutritional intake and preventing behaviors that counteract it.
Patients with anorexia nervosa frequently engage in secretive behaviors such as hiding food, pretending to eat, or inducing vomiting to avoid weight gain.
Therefore, the best nursing intervention is to directly observe the patient during and after meals to ensure food is not being discarded or purged.
This intervention is a foundational safety measure upon which other therapies, like structured meal plans, depend for success.

Option A: This is an invasive, last-resort measure used only for medically unstable patients (e.g., severe malnutrition, cardiac instability, or complete refusal to eat).
Option C: While a structured meal plan is a vital component of therapy, it is ineffective if the patient is secretly not adhering to it by throwing away food or purging.
Option D: This describes the long-term goal or desired outcome of the entire treatment process, not a specific, actionable nursing intervention.

Visual 1: Infographic: The Cycle of Anorexia Nervosa - Illustrating the thought patterns (fear of weight gain), behaviors (restriction, purging), and physical/emotional consequences.
Visual 2: Flowchart: Nursing Priorities in Eating Disorders - A visual guide starting with physiological safety (monitoring vitals, preventing purging) and progressing to psychological support and nutritional education.

Clinical Relevance

Nursing practice connection: Knowing Priority Nursing Interventions for Anorexia Nervosa helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
The nurse's role is to maintain a fine balance between empathetic support and firm, consistent boundaries to ensure patient safety.
Monitoring for purging is not just about watching; it's about creating a safe space where the patient can eventually learn to manage anxiety without resorting to harmful behaviors.
What if? If the patient becomes hemodynamically unstable with a heart rate below 40 bpm and severe hypotension, the priority shifts to immediate medical stabilization, and 'Food given forcefully by tube' (Option A) becomes a necessary life-saving intervention.

How to Approach the Question

First, identify the core issue: The question asks for the 'best' nursing intervention for anorexia nervosa, which implies a priority-setting question.
Analyze the diagnosis: Anorexia nervosa involves a fear of weight gain and behaviors to prevent it. This means a key problem is ensuring food intake and retention.
Evaluate each option: Distinguish between goals, plans, and actions. 'Maintain healthy weight' is a goal. 'Structural therapy' is a plan. 'Forceful tube feeding' and 'Checking for vomiting' are actions.
Prioritize the actions: Between the two actions, determine which is the most fundamental and immediate. Forceful feeding is an extreme measure. Checking for purging/hiding food is a necessary, routine safety check to make any nutritional plan work.
Select the option that represents the most immediate and foundational nursing action for patient safety in this specific context.

Concept Tested & Keywords

Concept Tested: Priority Nursing Interventions for Anorexia Nervosa
Stem keywords: anorexia nervosa, 16-years old girl, nursing intervention
Lead-in keywords: best
Clinical cues: Patient is a 16-year-old, an age where peer influence and body image concerns are high.
Clinical cues: Diagnosis is anorexia nervosa, which is characterized by distorted body image and compensatory behaviors.

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