Which of the following primary concern in a psychiatric patient who is suffering from eating disorders?

NORCET-7 Mains-2024

Psychiatric Nursing

Medium

Appeared in: NORCET-7 Mains-2024

Explanation

Eating disorders, particularly those involving purging behaviors like vomiting or laxative abuse, cause significant loss of essential electrolytes.
The most life-threatening complication is hypokalemia (low potassium), which can lead to fatal cardiac dysrhythmias and cardiac arrest.
According to nursing prioritization frameworks (e.g., Maslow's Hierarchy, ABCs), addressing immediate physiological life threats is the highest priority.
Therefore, correcting the electrolyte imbalance is the primary concern to ensure patient survival before addressing other psychological or nutritional goals.

Option B: While malnutrition can lead to leukopenia and an increased risk of infection, this is typically a less immediate threat compared to the risk of sudden cardiac death from electrolyte disturbances.
Option C: Measuring vital signs is a crucial assessment or monitoring activity, not a therapeutic intervention. It helps detect problems like bradycardia and hypotension but does not correct the underlying cause.
Option D: Recording an Intake/Output (I/O) chart is an essential monitoring tool to assess fluid balance and guide treatment. Like vital signs, it is an assessment, not the primary corrective intervention.

Visual 1: Diagram: ECG changes in hypokalemia. This visual would show T-wave flattening, ST-segment depression, and the appearance of a U-wave, helping students connect the electrolyte imbalance to its dangerous cardiac effects.
Visual 2: Flowchart: Nursing priorities in eating disorder management. This would visually place 'Physiological Stabilization (Correct Electrolytes)' at the top, followed by nutritional rehabilitation and psychological support.

Clinical Relevance

Nursing practice connection: Use the key finding related to Prioritizing nursing care for patients with eating disorders to guide bedside assessment, documentation, and the next nursing action.
Nurses must recognize that patients with eating disorders, especially bulimia, may appear to be of normal weight but can have severe, life-threatening electrolyte imbalances.
A critical nursing responsibility is to monitor laboratory results closely and immediately report critical values, such as low potassium, to the provider for urgent intervention.
Patient safety depends on vigilant monitoring for signs of cardiac distress, including irregular pulse, dizziness, or fainting, which could indicate an underlying arrhythmia.

How to Approach the Question

First, identify the question as a 'priority' question by looking for keywords like 'primary concern,' 'first,' or 'most important.'
Next, analyze the options and categorize them as either 'assessments' (gathering data) or 'interventions' (taking action). In this case, measuring vitals and recording I/O are assessments, while correcting imbalances is an intervention.
Apply nursing prioritization principles. Maslow's Hierarchy of Needs places physiological needs (like fluid and electrolytes) at the base, making them the top priority. The ABC (Airway, Breathing, Circulation) framework also points to circulation (cardiac function) as a top priority.
Evaluate the immediate risk. An electrolyte imbalance poses a direct and immediate threat to life (cardiac arrest), whereas infection is a potential but usually less immediate risk.
Conclude that the intervention addressing the most immediate life-threatening physiological problem is the primary concern.

Concept Tested & Keywords

QCRHxd570RZyp4HAVHB54q