A 17-year-old female is admitted to the inpatient psychiatric unit after her parents found a journal describing intense fear of weight gain, restrictive eating, and purging behaviors over the past 8 months. Her current weight is 15% below ideal body weight, and she insists she 'looks fat.' During the initial assessment, she is cooperative but minimizes her symptoms, stating 'I eat enough, everyone is overreacting.' Which nursing intervention is the priority at this time?
- Encourage the client to set her own meal goals to support autonomy
- Confront the client about her distorted body image to promote insight
- Monitor vital signs and laboratory values for physiologic complications of malnutrition
- Initiate a behavioral contract focused on weight restoration targets