A client with binge eating disorder reports feeling guilty and depressed after episodes of binge eating. Which nursing diagnosis is most appropriate for this client?

Choice A rationale:

Significant weight loss or failure to achieve expected weight gain is consistent with the diagnosis of avoidant/restrictive food intake disorder (ARFID) ARFID is characterized by a lack of interest in eating or food, avoidance based on sensory characteristics of food, concern about the aversive consequences of eating, and avoidance of foods due to a previous negative experience. This avoidance can lead to inadequate nutrient intake and, consequently, significant weight loss or the inability to achieve expected weight gain, especially in children.

Choice B rationale:

Recurrent episodes of binge eating followed by inappropriate compensatory behaviors are not indicative of avoidant/restrictive food intake disorder (ARFID) This behavior is more characteristic of bulimia nervosa, which involves cycles of binge eating followed by behaviors like vomiting, laxative use, or excessive exercise to compensate for the overeating.

Choice C rationale:

Persistent eating of nonnutritive, nonfood substances is a characteristic of pica disorder, not avoidant/restrictive food intake disorder (ARFID) Pica involves the consumption of substances such as dirt, paint, hair, or cloth, which have no nutritional value.

Choice D rationale:

Repeated regurgitation of food is a characteristic of rumination disorder, not avoidant/restrictive food intake disorder (ARFID) Rumination disorder involves the regurgitation of food that is then either re-chewed, re-swallowed, or spit out, without an associated medical condition.

Choice A rationale:

Ineffective Coping is the most appropriate nursing diagnosis for a client with binge eating disorder who reports feeling guilty and depressed after episodes of binge eating. Binge eating disorder is characterized by recurrent episodes of consuming large amounts of food within a discrete period, accompanied by a sense of loss of control. The guilt and depression reported by the client are emotional responses to these episodes. Ineffective Coping reflects the client's inability to manage and adapt to these negative emotions in a healthy manner. It addresses the psychological distress that often accompanies binge eating behaviors.

Choice B rationale:

Disturbed Body Image is not the most appropriate nursing diagnosis for this client. While individuals with binge eating disorder may experience body dissatisfaction due to weight gain resulting from their binge episodes, the primary focus of this client's distress is on feelings of guilt and depression, which are better captured by the Ineffective Coping diagnosis.

Choice C rationale:

Imbalanced Nutrition: More Than Body Requirements is not the most suitable nursing diagnosis for this client. While binge eating disorder involves excessive food consumption during episodes, the diagnosis of Imbalanced Nutrition is usually reserved for clients who have issues with nutrient intake that lead to alterations in physical health, such as obesity or malnutrition.

Choice D rationale:

Risk for Impaired Skin Integrity related to dental erosion is not the most relevant nursing diagnosis for this client. While binge eating may lead to dental erosion over time due to frequent exposure to stomach acid during episodes, this choice does not address the primary psychological concerns of guilt and depression.