A nurse is caring for a client with a current blood potassium level of 5.4 mEq/L (3.5-5 mEq/L). Which finding would this client have?

A) Dysphagia: While dysphagia (difficulty swallowing) can occur in individuals with long-term alcohol use, especially if there is coexisting neurological damage or esophageal disorders, it is not specifically associated with vomiting and diarrhea in the context of this scenario. The primary concern here involves electrolyte imbalances.

B) Hypoactive deep tendon reflexes (DTR): Hypoactive DTRs are typically associated with hypermagnesemia rather than hypomagnesemia. In this case, the client's condition is more likely to lead to electrolyte deficiencies, including hypomagnesemia, due to vomiting, diarrhea, and poor nutritional intake.

C) Hypomagnesemia: Chronic alcohol use often results in nutritional deficiencies, and vomiting and diarrhea can further exacerbate this by depleting electrolytes. Hypomagnesemia is a common finding in long-term alcoholics due to poor dietary intake, gastrointestinal losses, and renal losses. This can lead to symptoms such as muscle weakness, tremors, and altered mental status. Hypomagnesemia is particularly concerning because it can affect cardiovascular stability and neuromuscular function.

D) Positive Chvostek sign: A positive Chvostek sign is indicative of hypocalcemia, which can occur secondary to hypomagnesemia. However, it is not as directly associated with chronic alcoholism as hypomagnesemia itself. The positive Chvostek sign involves a facial muscle spasm in response to tapping the facial nerve and indicates neuromuscular irritability due to low calcium levels. While related, the primary electrolyte imbalance expected here is hypomagnesemia.

A) "Your daily intake of fats should be limited to no more than 35% of your daily caloric intake":

Current dietary guidelines typically recommend limiting fat intake to less than 30% of total daily calories, not 35%, for optimal heart health. This recommendation is slightly higher than what is generally advised for managing high cholesterol.

B) "You should avoid trans-fat as much as possible":

Trans fats significantly increase LDL cholesterol (bad cholesterol) levels and decrease HDL cholesterol (good cholesterol). Avoiding trans fats is crucial in managing high cholesterol and reducing cardiovascular risk, making this the most important recommendation.

C) "Your main sources of protein should be red meat":

Red meat, particularly processed red meat, is associated with higher cholesterol levels and cardiovascular risk. It is generally recommended to choose lean proteins, such as fish, poultry, and plant-based sources, over red meat.

D) "Fats provide the highest amount of energy per gram":

While fats do provide more energy per gram than carbohydrates or proteins, this statement does not directly address the management of cholesterol levels. The focus should be on the type of fats consumed rather than their energy content.

E) "Your intake of fats should be unsaturated fats":

While consuming unsaturated fats is beneficial, avoiding trans fats specifically addresses a more immediate concern for those with high cholesterol. Option B emphasizes the importance of eliminating harmful fats.