A nurse is caring for a 24-year-old female client with anorexia nervosa on an inpatient eating disorder unit. Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client’s progress.

Rationale for correct condition The client has a BMI of 13–14.1, indicating severe malnutrition. Clinical signs include bradycardia, hypotension, hypothermia, electrolyte imbalances (hyponatremia, hypokalemia), and cachexia. These findings are consistent with anorexia nervosa, not bulimia or endocrine disorders. Improvement in weight and labs by December 15 supports ongoing nutritional rehabilitation. The persistent bradycardia and low BP reflect the chronic effects of starvation. Rationale for correct actions IV fluids with electrolyte replacement correct dehydration and restore sodium and potassium levels, preventing cardiac arrhythmias and renal impairment. Electrolyte normalization is critical in refeeding. Cognitive-behavioral therapy (CBT) addresses distorted body image, fear of weight gain, and restrictive behaviors, forming the cornerstone of long-term recovery in anorexia nervosa. Rationale for correct parameters Daily weight tracking provides objective data on nutritional rehabilitation and guides caloric adjustments. It also helps detect fluid shifts or refeeding syndrome. Heart rate and rhythm monitoring is essential due to the risk of bradyarrhythmias and sudden cardiac death in malnourished clients, especially during refeeding. Rationale for incorrect conditions Bulimia nervosa involves binge-purge cycles, not severe weight loss or bradycardia. Hypothyroidism causes fatigue and weight gain, not cachexia or electrolyte loss. Addison’s disease presents with hyperpigmentation, hypotension, and hyperkalemia—not starvation or fear of weight gain. Rationale for incorrect actions Thyroid hormone therapy is not indicated without hypothyroidism. High-calorie snacks are helpful but must be cautiously introduced to avoid refeeding syndrome. Corticosteroids treat adrenal insufficiency, not anorexia nervosa. Rationale for incorrect parameters TSH and cortisol levels are not primary concerns unless endocrine dysfunction is suspected. Binge-purge frequency is relevant to bulimia, not restrictive anorexia. Take home points Anorexia nervosa with severe malnutrition presents with bradycardia, hypotension, and electrolyte imbalances. Treatment includes cautious rehydration, electrolyte correction, and psychotherapy. Weight and cardiac monitoring are essential during nutritional rehabilitation. Differentiate from bulimia, hypothyroidism, and adrenal insufficiency based on clinical and lab findings.