The nurse is caring for a client admitted to an inpatient eating-disorder unit. Exhibits For each potential provider's assessment finding, click to specify if the finding is consistent with anorexia nervosa or bulimia nervosa. Each finding may support more than 1 disease process.

Lanugo: Clients with anorexia nervosa often develop fine, soft hair (lanugo) on the face and body as the body’s compensatory response to heat loss from extreme fat depletion. This finding reflects prolonged malnutrition and low body weight. It is rarely seen in bulimia nervosa, where clients maintain a normal or slightly above-normal weight. Skin color: In anorexia nervosa, the skin may appear pale, dry, or yellow due to poor perfusion, vitamin deficiencies, and loss of subcutaneous fat. These changes are indicators of chronic starvation. Bulimia clients usually have normal skin tone since their caloric intake is more adequate. Body Mass Index: A BMI of 15.4 kg/m² indicates severe underweight consistent with anorexia nervosa, where restriction leads to significant weight loss and malnutrition. Bulimia typically presents with a BMI within or near the normal range due to binge–purge cycles without sustained restriction. Potassium level: Hypokalemia (2.8 mEq/L) can occur in both anorexia and bulimia. In anorexia, it results from malnutrition and possible laxative abuse; in bulimia, it occurs due to vomiting or diuretic use. In both cases, low potassium increases cardiac arrhythmia risk. Extremity assessment: Cold, cyanotic, or edematous extremities are more common in anorexia nervosa due to reduced circulation, hypotension, and protein loss. Bulimia clients rarely show these findings because they maintain better peripheral perfusion. Past medical history: The client’s generalized anxiety disorder supports anorexia nervosa, as anxiety and perfectionism are commonly linked to restrictive eating and body image disturbances. Bulimia is more associated with impulsivity and mood instability rather than anxiety alone.