The nurse reviews the Nurses' Notes from Day 1 at 1100. Exhibits 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.

Rationale: Encourage the client to discuss their feelings: Encouraging emotional expression is a key therapeutic approach in managing bulimia nervosa. It allows the client to explore underlying psychological issues, such as anxiety and fear of weight gain, which often contribute to disordered eating behaviors. Provide a reduced sodium diet: Sodium restriction is not indicated in this client. In fact, the client has a slightly low sodium level (134 mEq/L), and further restriction could worsen electrolyte imbalances, which are already contributing to cardiac instability. Request a prescription for fluoxetine: Fluoxetine, an SSRI, is approved for the treatment of bulimia nervosa and can reduce the frequency of binge-purge episodes. It is also effective in treating coexisting anxiety or depressive symptoms, which are common in this population. Request a prescription for bupropion: Bupropion is contraindicated in clients with eating disorders due to its seizure risk. In clients with bulimia, frequent vomiting and low electrolytes increase this risk significantly, making bupropion an inappropriate choice. Monitor daily intake and output: Monitoring intake and output helps evaluate hydration status and kidney function, both of which may be compromised due to chronic purging. It also helps track nutritional rehabilitation and prevent complications from electrolyte shifts.