A nurse is caring for a client in an emergency department (ED). Exhibits The nurse reviews the Nurses’ Notes from Day 1 at 1100. For each potential nursing intervention, click to specify if the intervention is anticipated or not anticipated for the client. There must be at least 1 selection in every row. There does not need to be a selection in every column.

Anticipated: Encourage the client to discuss their feelings: Psychosocial support is a key part of care for bulimia nervosa. Encouraging the client to discuss feelings helps address the underlying psychological factors contributing to binge-purge behaviors. Monitor daily intake and output: Due to recurrent vomiting, electrolyte imbalances, and risk for dehydration, monitoring fluid intake and output is necessary to prevent complications such as hypovolemia or worsening electrolyte disturbances. Request a prescription for fluoxetine: Fluoxetine (SSRI) is commonly prescribed for clients with bulimia nervosa to help reduce binge-purge behaviors and address comorbid anxiety or depression. Not Anticipated: Provide a reduced sodium diet: This client has hyponatremia (sodium 134 mEq/L), so sodium restriction is not appropriate. The priority is to restore normal electrolyte balance, not restrict sodium intake. Request a prescription for bupropion: Bupropion is contraindicated in eating disorders with purging behaviors due to increased risk of seizures. It is therefore not appropriate for this client.