A nurse is assessing a client who has received treatment for hypernatremia. Which of the following findings indicates the treatment has been effective?

Choice A reason: Prealbumin is a protein that is synthesized by the liver and reflects the current nutritional status of the client. It has a short half-life of 2 to 3 days, which makes it a sensitive indicator of changes in protein intake. Prealbumin levels are decreased in clients who are malnourished or have inflammation, infection, or liver disease. The nurse should monitor the prealbumin levels of the client who is receiving total parenteral nutrition to ensure that they are within the normal range of 15 to 36 mg/dL.

Choice B reason: Folic acid is a water-soluble vitamin that is involved in DNA synthesis, cell division, and red blood cell production. Folic acid levels are decreased in clients who have malabsorption, alcoholism, or certain medications, such as methotrexate or phenytoin. The nurse should assess the folic acid levels of the client who is receiving total parenteral nutrition, but it is not the priority test to confirm adequate nutrition.

Choice C reason: Magnesium is a mineral that is involved in many enzymatic reactions, muscle contraction, nerve transmission, and bone formation. Magnesium levels are decreased in clients who have malnutrition, diarrhea, vomiting, or diuretic use. The nurse should evaluate the magnesium levels of the client who is receiving total parenteral nutrition, but it is not the priority test to confirm adequate nutrition.

Choice D reason: Transferrin is a protein that transports iron in the blood and reflects the iron stores of the client. Transferrin levels are decreased in clients who have iron deficiency anemia, chronic disease, or liver disease. The nurse should check the transferrin levels of the client who is receiving total parenteral nutrition, but it is not the priority test to confirm adequate nutrition.

Choice A reason: Diabetes mellitus is not a likely complication of malnutrition, as it is caused by insufficient insulin production or action, not by inadequate food intake. Malnutrition may worsen the outcomes of diabetes, but it does not cause it.

Choice B reason: Pressure injury is a common complication of malnutrition, as it is caused by impaired tissue perfusion and oxygenation due to poor nutrition. Malnutrition can lead to loss of muscle mass, subcutaneous fat, and skin integrity, which increase the risk of developing pressure ulcers.

Choice C reason: Heat intolerance is not a direct complication of malnutrition, as it is caused by impaired thermoregulation due to hormonal or neurological disorders, not by insufficient food intake. Malnutrition may affect the body's ability to cope with heat stress, but it does not cause it.

Choice D reason: Gastroesophageal reflux disease (GERD) is not a typical complication of malnutrition, as it is caused by the backflow of gastric contents into the esophagus due to a weak or incompetent lower esophageal sphincter, not by inadequate food intake. Malnutrition may aggravate the symptoms of GERD, but it does not cause it.