A practical nurse (PN) is caring for a newly admitted client diagnosed with anorexia nervosa. The PN is assisting with the client's first scheduled dinner on the inpatient eating disorders unit. Arrange the following nursing actions in the correct chronological order of implementation.
- 1Inform the client of the 30-minute time limit and behavioral expectations for the meal.
- 2Sit with the client at the dining table to monitor intake and provide a supportive presence.
- 3Remove the food tray promptly when the designated mealtime expires.
- 4Accompany the client to a supervised common area for one hour of continuous observation.
- 5Document the exact percentage of food consumed and the client's emotional response.
Answer
The correct sequence is: Informing the client of limits, sitting with the client during the meal, removing the tray when time expires, accompanying the client for post-meal observation, and finally documenting the intake.
Clients with anorexia nervosa require a highly structured milieu to address altered eating patterns and prevent compensatory behaviors. The chronological process begins with clear limit setting prior to the meal. During the meal, direct observation and support are provided by the PN. Once the strict time limit is reached, the tray must be removed immediately to enforce boundaries. Following the meal, the client must be continuously observed for a specified period (usually 1 hour) to prevent purging, exercising, or discarding hidden food. Finally, once the client is safely monitored, the nurse documents the precise intake and behavioral observations.
Step-by-Step Solution
Key Concept
Eating Disorders Milieu Management