A client with a neurological disorder has difficulty swallowing. The nurse should take special care with the client’s diet because of a potential risk of imbalanced nutrition. Which measure may be taken by the nurse to ensure that the client’s diet allows for easy swallowing?

Reasoning:

Choice A reason: Bleeding, particularly gastrointestinal, is the most common cause of iron deficiency anemia in males and postmenopausal females. Blood loss reduces iron stores, as hemoglobin contains iron, and chronic bleeding (e.g., from ulcers or colon cancer) depletes iron faster than dietary intake can replenish, leading to anemia.

Choice B reason: Chronic alcohol use may contribute to anemia through nutritional deficiencies or liver disease, but it is not the primary cause. Alcohol can impair folate metabolism or cause gastrointestinal bleeding, but direct blood loss is a more common and significant driver of iron deficiency in these populations.

Choice C reason: Menorrhagia, or heavy menstrual bleeding, is a common cause of iron deficiency anemia in premenopausal women, not males or postmenopausal females. After menopause, menstruation ceases, eliminating this as a cause, making bleeding from other sources, like the gastrointestinal tract, more relevant.

Choice D reason: Iron malabsorption, as in celiac disease or gastric surgery, can cause iron deficiency but is less common than bleeding. Malabsorption impairs dietary iron uptake, but chronic blood loss, especially from gastrointestinal sources, is the leading cause in males and postmenopausal females due to higher prevalence.

Reasoning:

Choice A reason: A sodium level of 140 mEq/L is within the normal range and not diagnostic of Addison’s disease. This condition, caused by adrenal insufficiency, typically leads to hyponatremia due to reduced aldosterone, which decreases sodium reabsorption, making a normal sodium level uncharacteristic of the disease.

Choice B reason: A glucose level of 100 mg/dL is normal and not specific to Addison’s disease. Hypoglycemia is more common due to cortisol deficiency, which impairs gluconeogenesis. A normal glucose level does not support the diagnosis, as it does not reflect the metabolic disruptions of adrenal insufficiency.

Choice C reason: A blood pressure of 135/90 mm Hg is elevated but not diagnostic of Addison’s disease. The condition typically causes hypotension due to reduced aldosterone and cortisol, leading to low blood volume and vascular tone. Hypertension suggests another etiology, not adrenal insufficiency.

Choice D reason: A potassium level of 6.0 mEq/L indicates hyperkalemia, a diagnostic sign of Addison’s disease. Aldosterone deficiency reduces potassium excretion in the kidneys, leading to elevated serum potassium. This, combined with hyponatremia and hypotension, is a hallmark of adrenal insufficiency, making hyperkalemia a key diagnostic finding.