A nurse is performing an admission assessment for an older adult client. The nurse should identify that which of the following findings is a manifestation of possible elder maltreatment?

Choice A rationale:

The sodium level of 140 mEq/L is within the normal range for children, which is 135 to 145 mEq/L. Sodium levels may be low in nephrotic syndrome due to fluid retention and dilutional hyponatremia, but this is not the case for this child.

Choice B rationale:

The platelet count of 350,000/mm3 is within the normal range for children, which is 150,000 to 450,000/mm3. Platelet levels may be elevated in nephrotic syndrome due to increased production by the bone marrow in response to inflammation and infection, but this is not the case for this child.

Choice C rationale:

The nurse should report the protein level of 2 g/dL to the provider, as this is abnormally low and indicates severe proteinuria. Proteinuria is a hallmark of nephrotic syndrome, as the glomeruli become damaged and allow protein to leak into the urine. Normal protein levels for children are 6 to 8 g/dL. Low protein levels can lead to edema, hypoalbuminemia, and hyperlipidemia.

Choice D rationale:

The cholesterol level of 170 mg/dL is within the normal range for children, which is less than 200 mg/dL. Cholesterol levels may be high in nephrotic syndrome due to increased synthesis by the liver as a compensatory mechanism for low protein levels, but this is not the case for this child.

Choice A rationale:

Comfrey is not commonly recommended as an herbal supplement for menopausal symptoms. It has been associated with potential liver toxicity.

Choice B rationale:

Ginkgo biloba is often used to improve cognitive function and circulation but is not typically used to address menopausal symptoms.

Choice C rationale:

Black cohosh is an herbal supplement that is commonly used by middle-aged women to help alleviate symptoms related to menopause, such as hot flashes and mood swings. Black cohosh may also have some benefits for bone health and cardiovascular health. However, black cohosh may also have some side effects and interactions with other medications, so the nurse should advise the women to consult their health care providers before taking it.

Choice D rationale:

Garlic is not typically used as an herbal supplement to manage menopausal symptoms; it is more commonly known for its potential cardiovascular benefits.