A nurse is assessing a patient with bulimia nervosa. Which of the following cardiovascular symptoms would the nurse expect to find?

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.

Choice A rationale:

Ignoring the client's beliefs to avoid escalating distress is not a therapeutic approach. Addressing cognitive distortions and irrational beliefs is crucial in helping the client reframe their thoughts and promote healthier behaviors.

Choice B rationale:

Encouraging the client to engage in self-isolation is counterproductive. Isolation can worsen the client's condition and hinder their recovery.

Choice C rationale:

Addressing cognitive distortions and irrational beliefs is the appropriate therapeutic approach. This involves working with the client to identify and challenge negative thought patterns, helping them develop a more realistic perception of their body image and self-worth.

Choice D rationale:

Avoiding discussing body image to prevent embarrassment is not effective. Open and sensitive discussions about body image are important in the therapeutic process to help the client gain insight into their feelings and beliefs.