A nurse assesses an older adult client who lives alone and is unable to drive a vehicle. Which of the following assessment areas of the nutritional history will most likely impact the client's nutritional status?

Exophthalmos:

Exophthalmos, or protruding eyeballs, is typically associated with hyperthyroidism (Graves' disease) rather than hypothyroidism. It results from the accumulation of fluid and swelling behind the eyeballs.

(b) Palpitations:

Palpitations, or rapid heartbeat, are more commonly associated with hyperthyroidism due to the increased metabolic rate and sympathetic nervous system stimulation. In hypothyroidism, bradycardia (slow heart rate) is more likely.

(c) Diaphoresis:

Diaphoresis, or excessive sweating, is not a typical finding in hypothyroidism. It is more commonly associated with conditions that cause autonomic dysfunction or hypermetabolic states.

(d) Weight gain:

Weight gain is a hallmark symptom of hypothyroidism. It occurs due to a slowing down of the metabolic rate, leading to reduced calorie expenditure and potential fluid retention.

A) Accessibility:

Accessibility refers to the client's ability to obtain food, which is crucial for nutritional status, especially for someone who lives alone and cannot drive. Difficulty in accessing grocery stores or markets can limit the variety and availability of nutritious food options, potentially leading to poor nutritional intake.

B) Food preparation:

Food preparation skills are important, but if the client has difficulty accessing food in the first place (due to transportation limitations), their ability to prepare meals becomes secondary. Accessibility to food sources is a more immediate concern for nutritional status.

C) Food preferences:

While food preferences can influence dietary choices, the ability to access food is a more fundamental issue that directly impacts nutritional intake, especially for someone who lives alone and has limited mobility.

D) Finances:

Financial constraints can certainly affect food choices and access to nutritious options. However, in this scenario, the primary concern is the physical accessibility to food sources, which directly impacts the client's ability to maintain adequate nutrition.