A nurse in a provider's office is caring for a client.

Exhibit 1

Medical History

Initial visit:

Client reports a sedentary lifestyle.

Client is lactose intolerant and denies taking vitamin supplements.

Client is a nonsmoker.

Client does not drink alcohol.

The nurse is reviewing the client's medical record. Which of the following findings places the client at risk for osteoporosis? (Select all that apply.)

A. Supine in low-Fowler's position:Low-Fowler's position does not effectively promote postural drainage for left lower-lobe atelectasis. This position would not use gravity to facilitate mucus drainage or improve ventilation to the affected lobe.

B. Side-lying with the right side of the chest elevated:While side-lying positions can be useful for postural drainage, lying with the right side elevated does not optimize drainage from the left lower lobe.

C. Prone with pillows under the lower extremities:Although the prone position can help improve oxygenation in some respiratory conditions, it is not ideal for targeting left lower-lobe atelectasis in postural drainage therapy.

D. Right lateral in Trendelenburg position:In this position, the left lower lobe is elevated, allowing gravity to assist in draining secretions toward the larger airways for clearance. The Trendelenburg position further enhances the effect of gravity on secretion drainage from the lower lobe.

A. Albumin 3.1 g/dL (3.5 to 5.0 g/dL)

Albumin is a protein produced by the liver, and its levels are commonly used as an indicator of nutritional status, particularly protein status. In clients with liver dysfunction and receiving continuous tube feeding, a low albumin level indicates protein deficiency. Albumin plays a crucial role in maintaining oncotic pressure in the blood vessels, and decreased levels can lead to fluid shifts and edema, among other complications.

B. Transferrin 400 mg/dL (250 to 380 mg/dL):

Transferrin is a protein involved in iron transport. While high transferrin levels may indicate iron deficiency, they do not directly reflect protein deficiency.

C. Uric acid 2.3 mg/dL (2.7 to 7.3 mg/dL):

Uric acid is a waste product of metabolism. Low uric acid levels are not indicative of protein deficiency; instead, they may be seen in conditions such as liver dysfunction or decreased production of uric acid.

D. Total iron-binding capacity 488 mcg/dL (250 to 460 mcg/dL):

Total iron-binding capacity measures the amount of iron that can be bound by transferrin. Elevated total iron-binding capacity may indicate iron deficiency, but it does not directly reflect protein deficiency.