A nurse is reviewing the laboratory values for a client who is receiving a phosphate binder with meals for end-stage renal disease. Which of the following values should indicate to the nurse that the treatment is effective?

Choice A rationale:
Total albumin is a valuable indicator of a client's nutritional status, but it has a longer half-life and is slower to reflect short-term changes. It may not accurately reflect the immediate effectiveness of total parenteral nutrition (TPN).
Choice B rationale:
Transferrin is a protein that transports iron in the body and is often used to assess iron deficiency. It is not a specific indicator of the effectiveness of TPN in the short term.
Choice C rationale:
Hemoglobin is a protein found in red blood cells and is responsible for oxygen transport. While it can be affected by nutritional status, it is not the most specific indicator of the effectiveness of TPN in the short term.
Choice D rationale:
Prealbumin (also known as transthyretin) is the best indicator for the nurse to monitor for the short-term effectiveness of TPN. Prealbumin has a short half-life of approximately 2 days, making it sensitive to changes in nutritional status and response to TPN. A decrease in prealbumin levels indicates inadequate nutritional support, while an increase suggests improved nutritional intake.

Choice A rationale:
Allowing the toddler to feed himself is an important aspect of promoting autonomy and developing fine motor skills. It encourages self-sufficiency and exploration of different food textures. However, close supervision is necessary to ensure the toddler's safety during feeding.
Choice B rationale:
Avoiding snacks between meals is not the most appropriate instruction for a toddler's nutritional needs. Toddlers have smaller stomach capacities and higher energy requirements due to their rapid growth. Healthy snacks can help meet their nutritional needs and prevent excessive hunger between meals.
Choice C rationale:
Providing different food for the toddler than the parents is not recommended. Ideally, toddlers should be exposed to the same nutritious foods that the family consumes. This practice helps establish healthy eating habits and exposes the toddler to a variety of foods.
Choice D rationale:
Setting meal times immediately after physical activity is not necessarily beneficial. While regular physical activity is important for toddlers, scheduling meals immediately after activity might lead to poor appetite or discomfort. It's generally better to ensure the toddler is well-rested and hungry before meals.