Patient with anorexia nervosa will have

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2024

Mental Health Nursing

Medium

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2024

Explanation

Anorexia nervosa induces a hypometabolic (low energy) state as the body's primary mechanism to conserve energy during severe starvation.
Bradycardia (a slow heart rate, often below 60 bpm) occurs as the heart's workload is reduced to save calories.
Hypotension (low blood pressure) results from decreased cardiac muscle mass, dehydration, and changes in autonomic nervous system function.
Hypothermia (low body temperature, often below 35.5°C or 95.9°F) is caused by the loss of insulating subcutaneous fat and a lowered metabolic rate.

Option A: Tachycardia and hypertension are signs of an increased metabolic rate or stress response, which is the opposite of the energy-conserving state seen in anorexia nervosa.
Option C: Tachycardia (a fast heart rate) is incorrect. The body slows the heart rate (bradycardia) to conserve energy in a state of prolonged starvation.
Option D: Hypertension and hyperthermia are incorrect. The body's response to starvation is to lower blood pressure and temperature to reduce energy expenditure.

Clinical Relevance

Nursing practice connection: Use the key finding related to Physiological effects of anorexia nervosa on vital signs to guide bedside assessment, documentation, and the next nursing action.
Close monitoring of vital signs is critical in patients with anorexia nervosa, as severe bradycardia (e.g., a heart rate below 40 bpm) or significant hypotension can indicate impending cardiovascular collapse and require immediate hospitalization.
These vital sign changes are physiologic adaptations to starvation; they are generally reversible with careful nutritional rehabilitation and weight restoration.
What if? If a patient with anorexia nervosa presents with a normal or high temperature (fever), it is a major red flag. Their baseline is hypothermia, so a 'normal' temperature can mask a serious underlying infection that their body cannot mount a full febrile response to.

How to Approach the Question

First, identify the core condition in the question stem: 'anorexia nervosa'.
Recall the fundamental pathophysiology of this condition, which is severe starvation leading to a hypometabolic (energy-saving) state.
Predict how a hypometabolic state would affect the body's main vital signs: The heart rate will slow down (bradycardia), blood pressure will drop (hypotension), and body temperature will decrease (hypothermia).
Scan the options to find the one that matches this predicted triad of signs.
Eliminate options containing opposite signs like tachycardia, hypertension, or hyperthermia, as they contradict the pathophysiology of starvation.

Concept Tested & Keywords

QjA4fxTArMrIQca0ADsxpT

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 1501-1503, 1499-1501

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 316-318