Diagnosis of advanced anorexia nervosa

A client is admitted to the emergency department with a diagnosis of advanced anorexia nervosa. The client is 5’4″ (1.6m) tall and weighs 79lb (35.8kg). On assessment, the nurse notes blood pressure of 82/50 mm Hg: cracked and bleeding lips: and dry, yellow skin. The nurse offers the client oral fluids, and the client replies, ” They’ll make me even fatter.” The nurse should base her next intervention on which assessment finding?
A. dry skin and cracked lips
B. refusal of fluids
C. low body weight
D. disturbed body image