Nurse is aware that the major health complication associated with intractable anorexia nervosa would be?

SJH Nursing Officer - 2019

Mental Health Nursing

Medium

Appeared in: SJH Nursing Officer - 2019

Explanation

The most severe and life-threatening complication of anorexia nervosa is cardiac dysrhythmia leading to cardiac arrest.
This is primarily caused by severe electrolyte imbalances, especially hypokalemia (low potassium), resulting from starvation and/or purging behaviors.
These electrolyte disturbances disrupt the heart's electrical conduction system, leading to bradycardia, prolonged QTc interval, and potentially fatal ventricular arrhythmias.
Cardiac complications are the leading cause of death in patients with anorexia nervosa, making it the most critical health risk to monitor.

Why Other Options Were Wrong

Option B: While glucose metabolism is affected in anorexia nervosa and hypoglycemia can occur, it is not the primary life-threatening complication compared to cardiac arrest.
Option C: Amenorrhea (absence of menstruation) is a very common sign and part of the diagnostic criteria for anorexia nervosa, reflecting hypothalamic-pituitary-gonadal axis suppression. However, it is a chronic complication and not an immediate threat to life.
Option D: Cold intolerance is a common and expected symptom of starvation due to the loss of subcutaneous fat and a slowed metabolic rate as the body tries to conserve energy. It is uncomfortable but not a major lethal complication.

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Clinical Relevance

Nursing practice connection: Knowing Major health complications of anorexia nervosa helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
In nursing practice, any patient with suspected or confirmed anorexia nervosa requires an immediate focus on cardiovascular stability. An ECG and baseline electrolyte panel are critical initial assessments.
The risk for cardiac arrest is highest at the patient's lowest weight and, paradoxically, during the initial phase of refeeding (refeeding syndrome). Nurses must monitor for signs of fluid overload, tachycardia, and new electrolyte shifts during this period.
What if the patient also engages in purging behaviors (self-induced vomiting or laxative abuse)? The risk of severe hypokalemia and cardiac arrest is even higher, necessitating more aggressive monitoring and electrolyte replacement.

How to Approach the Question

First, identify the core of the question: it asks for the 'major' health complication. In nursing, 'major' or 'priority' almost always refers to the most life-threatening condition.
Next, evaluate the options based on the ABCs (Airway, Breathing, Circulation) and immediate risk of death.
Option A, 'Cardiac dysrhythmias resulting to cardiac arrest,' is a direct and immediate threat to circulation and life.
Options B, C, and D (glucose intolerance, amenorrhea, cold intolerance) are all known consequences of anorexia nervosa, but they are either chronic, less severe, or not as immediately fatal as a cardiac arrest.
Therefore, by prioritizing the most acute and life-threatening condition, you can identify cardiac complications as the correct answer.

Concept Tested & Keywords

Concept Tested: Major health complications of anorexia nervosa
Stem keywords: anorexia nervosa, major health complication, intractable
Lead-in keywords: major
Negative lead-in flag: false

Question ID

QoM-mlUz5rU-QsyzKhGdBV

Reference Book

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1501-1503

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 317-319

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 6936-6938

Explanation

Why Other Options Were Wrong

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Question ID

Reference Book

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