A nurse is collecting data from a client who has anorexia nervosa. Which of the following findings should the nurse identify as an indication that the client has an impaired nutritional status?

Anorexia nervosa is a psychological eating disorder characterized by self-starvation and excessive weight loss. The chronic lack of caloric intake leads to a multisystem physiological slowing, where the body conserves energy by reducing metabolic activity, resulting in various autonomic and endocrine disturbances as compensatory mechanisms fail. A. Increased bowel sounds, or borborygmi, are associated with hyperactive peristalsis, often seen in cases of diarrhea or early bowel obstruction. In anorexia nervosa, the gastrointestinal tract typically experiences significant slowing, or gastroparesis, which results in hypoactive or diminished bowel sounds due to the lack of bolus-triggered motility. B. Constipation is a hallmark sign of impaired nutritional status in anorexia. It results from a combination of factors, including inadequate fiber and fluid intake, as well as a generalized slowing of peristalsis. The body’s starvation state leads to delayed colonic transit time as it attempts to extract maximum nutrients from minimal intake. C. Polyuria, or excessive urine output, is not a typical finding in anorexia nervosa unless the client is engaging in water loading to temporarily increase weight before a physical exam. More commonly, these clients suffer from dehydration and concentrated urine (oliguria) due to inadequate fluid intake and potential purging behaviors. D. Hyperkalemia is an elevated potassium level, which is rare in anorexia. Instead, these clients are at high risk for hypokalemia (low potassium), especially if they engage in purging behaviors such as self-induced vomiting or diuretic abuse. Hypokalemia is a critical finding that can lead to life-threatening cardiac dysrhythmias and muscle weakness.