The nurse is assessing an older female adult client’s nutritional status. Which finding indicates that the client has a nutritional deficiency?

Reference Ranges: Hemoglobin [12 to 16 g/dL (120 to 160 g/L)] Hematocrit [37% to 47% (0.37 to 0.47 volume fraction)] Albumin [3.5 to 5.0 g/dL (35 to 50 g/L)] Serum transferrin [250 to 380 mg/dL (2.5 to 3.80 g/L)]

Choice C reason:

Oatmeal with raisins and nuts, with skim milk and 1/2 grapefruit, is the best choice for reducing the risk of some cancers. Oatmeal is high in fiber, which has been linked to a lower risk of colorectal cancer. Raisins and nuts provide antioxidants and healthy fats, which can help protect cells from damage. Skim milk offers calcium, which is beneficial for bone health, and grapefruit is rich in vitamin C and other antioxidants that support the immune system and may help prevent cancer.

Choice A reason:

Pancakes with blueberries and maple syrup, and a turkey sausage patty, while containing some beneficial elements like blueberries, which are high in antioxidants, also include processed meats like turkey sausage. Processed meats have been linked to an increased risk of certain cancers, such as colorectal cancer. The high sugar content in maple syrup can also contribute to inflammation, which is not ideal for cancer prevention.

Choice B reason:

Scrambled eggs with roasted peppers and onions, lean ham, and toast provide a balanced meal with protein and vegetables. However, lean ham is a processed meat, which has been associated with an increased risk of cancer. While the vegetables offer beneficial nutrients, the presence of processed meat makes this option less ideal compared to the oatmeal choice.

Choice D reason:

Poached egg, bacon, biscuit, and canned peaches in light syrup include processed meats like bacon, which are linked to a higher risk of cancer. The biscuit is likely made from refined flour, which lacks the beneficial fiber found in whole grains. Canned peaches in light syrup contain added sugars, which can contribute to inflammation and are not recommended for cancer prevention.

Choice A reason:

Prediabetes in children is typically managed with lifestyle interventions, such as increased physical activity and dietary control, rather than insulin therapy.

Choice B reason:

Recommending an increase in caloric intake to avoid excessive weight loss is important but not the primary concern in this scenario. While maintaining a balanced diet is crucial for children with prediabetes, the immediate focus should be on managing blood glucose levels during physical activity. Increased caloric intake can help support the child’s energy needs, but it does not directly address the potential risks associated with exercise-induced hypoglycemia. Therefore, while caloric intake adjustments may be necessary, they should be secondary to ensuring proper insulin management.

Choice C reason:

Suggesting a less strenuous activity to reduce the risk for dehydration is not the best approach. Physical activity is beneficial for children with prediabetes as it helps improve insulin sensitivity and overall health. Instead of limiting the child’s activity, it is more effective to educate the family on proper hydration strategies and how to manage blood glucose levels during exercise. Encouraging regular physical activity, such as soccer, can help reduce the risk of developing type 2 diabetes and promote a healthy lifestyle. Proper hydration and monitoring can mitigate the risk of dehydration without restricting the child’s participation in sports.

Choice D reason:

Engaging in regular physical activity is a cornerstone in managing prediabetes in children. It enhances insulin sensitivity and helps maintain healthy blood glucose levels. The American Academy of Pediatrics recommends that all children, including those with diabetes mellitus, engage in at least 60 minutes of daily physical activity starting at 5 years of age. Therefore, encouraging the child to join a soccer team aligns with these guidelines and can be beneficial in reducing the risk of progressing to type 2 diabetes.