A nurse is reviewing the laboratory results of a female client who has liver dysfunction a receiving a continuous tube feeding. Which of the findings should the nurse identify as a protein deficiency?

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

Transferrin 400 mg/dL (250 to 380 mg/dL)

Uric acid 2.3 mg/dL (2.7 to 7.3 mg/dL)

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

Answer and Explanation

The Correct Answer is A

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.

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Correct Answer is B

Explanation

A. Use a trochanter roll:

A trochanter roll is a positioning device placed alongside the hip to prevent external rotation of the hip joint and maintain proper alignment of the lower extremities. While it is important for maintaining proper hip alignment, it does not specifically address preventing plantar flexion contractures.

B. Use foot splints.

Plantar flexion contractures occur when the muscles and tendons in the foot and ankle become shortened, leading to a fixed downward pointing of the foot. Foot splints are devices designed to maintain the foot in a neutral position, preventing the development of contractures by keeping the ankle dorsiflexed. They help stretch the muscles and tendons in the foot and ankle, preventing them from becoming shortened over time.

C. Apply an abduction pillow to the legs:

An abduction pillow is a positioning device used to maintain proper hip alignment and prevent adduction of the hips and knees. While it is essential for preventing hip contractures and maintaining hip alignment, it does not directly address preventing plantar flexion contractures.

D. Prop the feet up:

Elevating the feet may be beneficial for improving circulation and reducing swelling, but it does not specifically address preventing plantar flexion contractures. In fact, prolonged elevation of the feet without proper support may increase the risk of developing contractures by allowing the foot to remain in a plantar flexed position for extended periods.

A. "I will weigh myself once weekly." B. "I will take my new medication in the evening." C. "I will take a hot bath before going to bed." D. "I will leave a light on in my bathroom at night."

Correct Answer is D

Explanation

A. "I will weigh myself once weekly."Clients with heart failure should weigh themselves daily to monitor for fluid retention. A sudden weight gain (e.g., 2-3 lbs in 24 hours or 5 lbs in a week) may indicate worsening heart failure and should be reported to the provider.

B. "I will take my new medication in the evening."Hydrochlorothiazide is a diuretic that increases urine output. Taking it in the evening can lead to nocturia and sleep disturbances. Instead, it should be taken in the morning to minimize nighttime urination.

C. "I will take a hot bath before going to bed."Hot baths can cause vasodilation, leading to a drop in blood pressure (orthostatic hypotension), which increases the risk of dizziness and falls, especially in older adults taking diuretics. A warm (not hot) bath is safer.

D. "I will leave a light on in my bathroom at night."Older adults, especially those taking diuretics like hydrochlorothiazide, are at increased risk for nocturia and falls due to frequent trips to the bathroom. Keeping a light on in the bathroom at night enhances visibility and reduces the risk of falls, which is a major concern in this population.

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A nurse is reviewing the laboratory results of a female client who has liver dysfunction a receiving a continuous tube feeding. Which of the findings should the nurse identify as a protein deficiency?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is immobile. Which of the following interventions should the nurse plan to take to prevent plantar flexion contractures?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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