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학습 자료 둘러보기 →In patients with severe anorexia nervosa and a BMI below 15 kg/m², the primary threat is cardiovascular collapse. Starvation causes myocardial atrophy, reducing heart mass and contractility. This is compounded by electrolyte disturbances like hypokalemia and hypophosphatemia, which create a highly irritable myocardium prone to fatal arrhythmias.
The highest priority nursing action is continuous cardiac monitoring and preparation for medical interventions. All psychological, behavioral, or nutritional education interventions are secondary until the client is medically stable. The immediate goal is to detect and manage life-threatening arrhythmias and correct fluid and electrolyte imbalances.
Aggressive nutritional rehabilitation in this state risks refeeding syndrome, a lethal shift in electrolytes. Caloric intake must be initiated slowly and cautiously under strict medical supervision, with frequent monitoring of phosphorus, magnesium, and potassium levels.
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