Mandy, an adolescent girl is admitted to an acute care facility with severe malnutrition. After a thorough examination, the physician diagnoses anorexia nervosa. When developing the plan of care for this client, the nurse is most likely to include which nursing diagnosis?
A. Hopelessness
B. Powerlessness
C. Chronic low self-esteem
D. Deficient knowledge
Correct Answer: C. Chronic low self-esteem
Young women with chronic low self-esteem — are at the highest risk for anorexia nervosa because they perceive being thin as a way to improve their self-confidence. Anorexia nervosa is an illness of starvation, brought on by severe disturbance of body image and a morbid fear of obesity. People with anorexia nervosa attempt to maintain a weight that’s far below normal for their age and height.
Option A: Hopelessness is an inappropriate nursing diagnosis because clients with anorexia nervosa seldom feel hopeless; instead, they use food to control their desire to be thin and hope that restricting food intake will achieve this goal. Feelings of personal ineffectiveness, low self-esteem, and perfectionism are often part of the problem.
Option B: Major physical and psychological changes in adolescence can contribute to the development of eating disorders. Feelings of powerlessness and loss of control of feelings (in particular sexual sensations) lead to an unconscious desire to desexualize self. The patient often believes that these fears can be overcome by taking control of bodily appearance, development, and function.
Option D: Anorexia nervosa doesn’t result from a knowledge deficit, such as one regarding good nutrition. The patient sees herself as weak-willed, even though part of a person may feel a sense of power and control (dieting, weight loss). The patient feels helpless to change and requires assistance to problem-solve methods of control in life situations.
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