A nurse is assisting in the care of an adolescent in a pediatric clinic. Drag words from the choices below to fill in each blank in the following sentence. The client is at risk of developing dropdownanddropdown.

Rationale for correct choices: • Osteopenia: Chronic caloric restriction and low body weight, as seen in anorexia nervosa, decrease bone mineral density. The adolescent’s BMI of 16.1 (4th percentile) and prolonged low nutrient intake place her at high risk for osteopenia and subsequent fractures. Hormonal imbalances, including hypothalamic amenorrhea, further contribute to bone loss. • Heart failure: Severe malnutrition, electrolyte imbalances, and bradycardia (heart rate 48/min) increase the risk of cardiac complications. The adolescent’s hypotension (80/50 mm Hg) and irregular heart rhythm indicate strain on the cardiovascular system. Chronic energy deficit and electrolyte disturbances can progress to heart failure if not addressed promptly. Rationale for incorrect choices: • Hyperkalemia: The adolescent is more likely to develop hypokalemia due to malnutrition, vomiting, or laxative use, rather than hyperkalemia. Excessive potassium is uncommon in restrictive anorexia nervosa without exogenous supplementation. • Hyperthyroidism: The client’s weight loss is due to caloric restriction rather than endocrine overproduction. There is no clinical evidence of thyroid disease such as goiter or elevated metabolic signs to suggest hyperthyroidism. • Hypernatremia: While dehydration may occur in anorexia nervosa, the client reports regular fluid intake and has normal sodium-related vital signs. Hypernatremia is unlikely in this context compared with risks associated with malnutrition, bradycardia, and electrolyte depletion. Pancreatitis: While eating disorders can cause GI issues, pancreatitis is more commonly associated with alcohol use disorder or gallstones, rather than the restrictive type of anorexia.