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

A. Record between-meal snacks on the calorie count form: Between-meal snacks contribute significantly to a client's total daily caloric intake and must be included to obtain an accurate calorie count. Omitting these snacks can result in an incomplete dietary assessment, potentially leading to inaccurate evaluations of the client's nutritional status.
B. Begin the calorie count with the client's next evening meal: Calorie counts should begin as soon as the prescription is initiated, not delayed until a specific mealtime. Waiting to begin with the evening meal may result in missed intake data and reduce the accuracy of the assessment. Timely initiation ensures the healthcare team captures a complete and accurate picture of the client’s intake patterns.
C. Exclude liquids in the total calorie count: Liquids, especially those containing calories such as juice, milk, nutritional supplements, or sweetened beverages, must be included in a calorie count. Excluding these items can underestimate the client’s actual caloric intake and interfere with proper evaluation and planning of their nutritional needs.
D. Complete the calorie count for a 5-day period: A standard calorie count is typically conducted over a 72-hour (3-day) period, which is sufficient to identify trends and provide nutritional insights. Extending the count unnecessarily to 5 days may not yield additional useful data and can burden both clients and staff. The focus should be on consistency and completeness within the accepted timeframe.

A. Administer antiemetics following the meal: Administering antiemetics after meals is not effective in preventing nausea or vomiting, which can interfere with nutritional intake. For clients at risk of malnutrition, the goal is to promote adequate food consumption, and antiemetics should be given before meals if nausea is anticipated.
B. Provide mouth care before feeding: Providing oral hygiene before meals helps enhance taste perception and appetite, especially in long-term care clients who may experience dry mouth or poor oral health. It also reduces the risk of aspiration pneumonia by clearing away bacterial buildup. This simple but effective step promotes comfort and nutritional intake.
C. Assess for pain prior to mealtime: Pain can suppress appetite and reduce the client's willingness or ability to eat. Addressing pain before meals improves comfort and allows the client to focus on eating rather than being distracted by discomfort. Proper pain management is a vital part of a nutrition care plan for clients at risk for malnutrition.
D. Remove the bedpan from the client's sight: Removing unpleasant stimuli, such as a used or visible bedpan, helps create a more appetizing and dignified mealtime environment. Visual and olfactory triggers can suppress appetite, especially in vulnerable clients. Ensuring a clean and pleasant atmosphere supports improved nutritional intake.
E. Discourage snacks between meals: Discouraging snacks between meals can limit caloric intake in clients who already have reduced appetite or food intake. For those at risk of malnutrition, encouraging frequent small meals and nutritious snacks can be more effective in meeting daily nutritional needs. Restricting snacks may contribute to further calorie deficits.