A female client with anorexia nervosa describes herself as “a whale.” However, nurse’s assessment reveals that client is 5′ 8″ (1.7 m) tall and weighs only 90 lb (40.8 kg). Considering client’s unrealistic body image, which intervention should nurse Angel be included in plan of care?

Correct Answer: D. Telling the client of the nurse’s concern for her health and desire to help her make decisions to keep her healthy

A client with anorexia nervosa has an unrealistic body image that causes consumption of little or no food. Therefore, the client needs assistance with making decisions about health. Respond (confront) with reality when a patient makes unrealistic statements. The patient may be denying the psychological aspects of their own situation and is often expressing a sense of inadequacy and depression.

• Option A: Instead of protecting the client’s health, option A may serve to make the client defensive and more entrenched in her unrealistic body image. Allow the patient to draw a picture of self. It provides an opportunity to discuss the patient’s perception of self and body image and realities of an individual situation.
• Option B: Encourage personal development program, preferably in a group setting. Provide information about the proper application of makeup and grooming. Learning about methods to enhance personal appearance may be helpful to a long-range sense of self-esteem and image. Feedback from others can promote feelings of self-worth.
• Option C: Establish a therapeutic nurse-patient relationship. Within a helping relationship, the patient can begin to trust and try out new thinking and behaviors. Assist the patient to assume control in areas other than dieting and weight loss such as management of their own daily activities, work, and leisure choices. Feelings of personal ineffectiveness, low self-esteem, and perfectionism are often part of the problem. The patient feels helpless to change and requires assistance to problem-solve methods of control in life situations.