A home health care nurse is visiting an older adult client who tells the nurse that she is feeling tired, is unable to shop for groceries, and would like the nurse to shop for her. Shopping and performing personal errands for the client is prohibited in the nurse's job description. Which of the following is an appropriate nursing response?

A. While track marks could indicate drug use, this alone does not necessitate a report to an outside agency unless there is evidence of harm to self or others, or if there are suspicions of a substance abuse issue that warrants intervention.

B. Emancipated minors have the legal right to make their own medical decisions, including refusing treatment. In this case, the nurse would ensure the patient is informed of the risks of leaving and document the refusal, but there’s no requirement to disclose to an outside agency.
C. A spiral fracture can be indicative of abuse, particularly if the mechanism of injury is not consistent with the explanation provided. In many jurisdictions, healthcare providers are mandated reporters for suspected abuse or neglect in dependent adults.
D. This situation typically does not involve any legal or ethical obligation to report to outside agencies. Glomerulonephritis is a medical condition and does not indicate any need for disclosure, as it does not suggest abuse or neglect.

A. Ulcerative colitis can lead to iron deficiency anemia due to chronic inflammation, intestinal bleeding, and malabsorption of nutrients. The disease often affects the colon, which can result in blood loss and inadequate iron absorption.
B. A diet high in prepackaged and processed foods is often low in essential nutrients, including iron. These foods may lack whole grains, fruits, vegetables, and other sources of dietary iron, increasing the risk of iron deficiency anemia.
C. Treatment for gastrointestinal cancer, such as surgery or chemotherapy, can lead to changes in absorption and increased risk of bleeding. This history can significantly elevate the risk for developing iron deficiency anemia due to potential blood loss and malabsorption issues.
D. Gastric bypass surgery can lead to iron deficiency anemia due to reduced stomach size and changes in the gastrointestinal tract that impair nutrient absorption. Patients often need to supplement their diet with iron and other vitamins after surgery.
E. Eating red meat daily is generally associated with an adequate intake of heme iron, which is more easily absorbed by the body compared to non-heme iron found in plant sources. While it's important to consider overall dietary patterns, this particular factor does not typically pose a risk for iron deficiency anemia.