A client with HIV-III and wasting syndrome has inadequate nutrition. What assessment finding by the nurse best indicates that goals have been met for this client problem?

The client has a weight gain of 2 lb (1 kg) per month.

The client eats 90% of meals and snacks.

The client chooses high-protein food.

The client has decreased oral discomfort.

Answer and Explanation

The Correct Answer is A

Choice A rationale:
Weight gain is the most objective and reliable indicator of improved nutritional status in clients with wasting syndrome. It directly reflects an increase in lean body mass, which is essential for restoring health and function.
A weight gain of 2 lb (1 kg) per month is considered a safe and achievable goal for clients with HIV-III and wasting syndrome. This rate of weight gain promotes gradual replenishment of nutrient stores without overwhelming the body's systems.
While other assessment findings, such as increased food intake or decreased oral discomfort, may be positive signs, they do not necessarily guarantee that nutritional goals have been met. It's possible for a client to consume more calories without experiencing weight gain due to factors such as malabsorption or increased metabolic demands. Similarly, decreased oral discomfort may improve appetite but not ensure adequate nutrient intake.
Choice B rationale:
While eating 90% of meals and snacks is a positive sign, it does not guarantee adequate nutrient intake or weight gain. The client may still be consuming insufficient calories or experiencing malabsorption.
The focus of nutritional intervention for wasting syndrome is to increase lean body mass, which is best reflected by weight gain. Eating patterns alone may not accurately capture this progress.
Choice C rationale:
Choosing high-protein foods is important for supporting tissue repair and immune function, but it does not guarantee adequate overall caloric intake or weight gain. The client may still be consuming insufficient calories or experiencing malabsorption.
Weight gain is a more comprehensive indicator of improved nutritional status, as it reflects both protein intake and overall caloric balance.
Choice D rationale:
Decreased oral discomfort can improve appetite and facilitate food intake, but it does not guarantee adequate nutrient intake or weight gain. The client may still be consuming insufficient calories or experiencing malabsorption.
Weight gain is a more direct and reliable indicator of improved nutritional status, as it reflects the actual utilization of nutrients for tissue repair and growth.

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Correct Answer is B

Explanation

A. Spiritual care in line with the family's belief system: This option aligns with the principles of hospice care, which emphasize holistic support for both the patient and their family, including addressing spiritual needs. Therefore, this intervention is appropriate and should be included in hospice care.

B. Surgery to remove plaques from the client's cerebral arteries to prevent future strokes: This intervention contradicts the philosophy of hospice care, which prioritizes comfort and quality of life for patients with life-limiting illnesses rather than aggressive treatments aimed at prolonging life or preventing future complications. Therefore, this intervention would not be included in hospice care and indicates a need for further teaching.

C. Psychosocial support aimed at the family's response to their loved one's imminent death: Hospice care recognizes the significant impact of a terminal illness on the patient's family and provides psychosocial support to help them cope with their emotions and prepare for the patient's death. This intervention is consistent with hospice principles and should be included in the care plan.

D. A primary focus on the client's quality of life in the time until the client's death: This is a fundamental aspect of hospice care, which prioritizes the patient's comfort, dignity, and overall well-being during their remaining time. Therefore, this intervention is appropriate and aligns with hospice philosophy.

A. Beginning each day with a set of vital signs obtained for each client B. Maintaining a standardized schedule for bathing for all clients C. Encouraging clients' family members to assist with feeding D. Ensuring that medications are administered by nurses

Correct Answer is D

Explanation

A. Beginning each day with a set of vital signs obtained for each client: While monitoring vital signs is important, performing this task daily for all clients may not always be necessary and could lead to unnecessary resource utilization. Vital signs should be assessed based on individual client needs and as indicated by their condition or treatment plan.

B. Maintaining a standardized schedule for bathing for all clients: While having a standardized schedule for bathing may streamline workflow, it may not always meet the individual needs and preferences of each client. Flexibility in scheduling based on individual preferences, care needs, and physical condition may be more appropriate to provide personalized care.

C. Encouraging clients' family members to assist with feeding: While family involvement can be beneficial, encouraging family members to assist with feeding may not always be feasible or appropriate for all clients. Some clients may require specialized feeding techniques or supervision by trained staff to ensure safety and proper nutrition.

D. Ensuring that medications are administered by nurses: This option ensures that medications are safely administered by qualified healthcare professionals who are trained to assess medication orders, administer medications correctly, monitor for potential side effects or adverse reactions, and provide education to clients regarding their medications. Adhering to this practice helps prevent medication errors and ensures the safe and effective use of medications, ultimately contributing to quality care and cost-effectiveness.

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A client with HIV-III and wasting syndrome has inadequate nutrition. What assessment finding by the nurse best indicates that goals have been met for this client problem?

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