NIMHANS Nursing Officer - 2019
Mental Health Nursing
Medium
Priority nursing Assessment in Anorexia nervosa?
Appeared in: NIMHANS Nursing Officer - 2019
Explanation
- According to Maslow's Hierarchy of Needs, physiological needs are the most fundamental and must be met first to sustain life.
- Anorexia nervosa causes severe malnutrition and fluid/electrolyte imbalances, which can lead to life-threatening complications like cardiac arrhythmias, organ failure, and profound hypotension.
- Therefore, the priority nursing assessment must focus on the client's physical health status to identify and manage these immediate medical dangers.
- Addressing physiological instability is a prerequisite for any effective psychological or social intervention.
Why Other Options Were Wrong
- Option A: Social isolation is a psychosocial problem. While it is a common and important issue in anorexia nervosa, it does not pose an immediate threat to the client's life compared to medical complications.
- Option B: Family problems are often a contributing factor and are crucial to address in long-term therapy (especially for adolescent patients), but they are not the initial priority during an acute medical crisis.
- Option C: Depression and distorted body image are core psychological features of anorexia nervosa. However, these cognitive and emotional issues cannot be effectively addressed until the client's brain and body are adequately nourished and physiologically stable.
Related Visual
Clinical Relevance
- Nursing practice connection: Safe nursing care depends on performing Prioritization of nursing assessments in anorexia nervosa in the correct sequence, documenting the action clearly, and monitoring for the expected response.
- Nurses must be vigilant for signs of refeeding syndrome when nutritional support is initiated. This potentially fatal condition is caused by rapid shifts in fluids and electrolytes and requires careful monitoring of phosphate, potassium, and magnesium.
- Continuous cardiac monitoring is essential for clients who are severely malnourished or exhibit bradycardia or arrhythmias, as sudden cardiac arrest is a leading cause of death in anorexia nervosa.
- What if? If a client with anorexia nervosa is medically stable but actively suicidal, the immediate priority shifts to ensuring safety from self-harm. This involves one-to-one observation and initiating suicide precautions, which becomes a safety need that is as critical as physiological needs in that moment.
How to Approach the Question
- First, identify the question type. This is a 'priority' question, which asks you to determine the most important action or assessment.
- Recall standard prioritization frameworks in nursing, such as Maslow's Hierarchy of Needs and the ABCs (Airway, Breathing, Circulation).
- Analyze the patient's condition: Anorexia nervosa is a psychiatric disorder with severe, life-threatening physical complications.
- Apply the framework: Maslow's hierarchy dictates that physiological needs (survival) must be addressed before psychosocial needs (love, esteem, etc.).
- Evaluate the options: Categorize each option as either a physiological need or a psychosocial need. 'Health issues' represents physiological needs, while 'social isolation,' 'family problem,' and 'depression' are psychosocial.
- Select the option that addresses the most critical, life-sustaining need. In this case, assessing and managing physical health issues is the clear priority to prevent death.
Concept Tested & Keywords
- Concept Tested: Prioritization of nursing assessments in anorexia nervosa.
- Stem keywords: Priority nursing Assessment, Anorexia nervosa
- Lead-in keywords: Priority
Question ID
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Reference Book
E6 Psychology Applied Sreevani 5e p. 210-212
E6 Psychology Applied Sreevani 6e Sem1 p. 211-213
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 6944-6946
Practise the full NIMHANS Nursing Officer - 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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