A nurse is planning dietary teaching for a client who adheres to a vegan diet. The nurse should identify that the client is at greatest risk for which of the following nutrient deficiencies?

Choice A rationale:
The nurse should identify that a client following a vegan diet is at risk for a folic acid deficiency. Folate, or folic acid, is a B vitamin found in various foods, including animal products. Since vegans exclude animal products from their diet, they might have a lower intake of folic acid-rich foods. Folic acid is important for cell division and the formation of DNA, making it essential for overall health.
Choice B rationale:
The nurse should also identify that a client following a vegan diet is at risk for a vitamin D deficiency. Vitamin D is primarily obtained through exposure to sunlight and is also found in certain animal-based foods. Since vegans avoid animal products, they might not get enough vitamin D from their diet. Vitamin D is important for bone health, immune function, and various other physiological processes.
Choice C rationale:
The risk of a magnesium deficiency is not specific to a vegan diet. While certain plant-based foods contain magnesium, it's not a common deficiency associated solely with vegan diets. Magnesium is involved in many bodily functions, including muscle and nerve function, but deficiencies are more often related to factors other than diet.
Choice D rationale:
Vitamin C deficiency is not a significant concern for individuals following a vegan diet. Vitamin C is abundantly available in various fruits and vegetables, which are staples of a vegan diet. As long as a vegan diet includes a variety of fresh produce, meeting the requirements for vitamin C is generally achievable.

Choice A rationale:
Temperature 38.4°C (101.1°F) An elevated temperature could indicate an infection, which would not be a therapeutic response to total parenteral nutrition (TPN). TPN is provided to support the client's nutrition and help improve their condition; an elevated temperature might suggest ongoing illness.
Choice B rationale:
BMI 18.5 A BMI of 18.5 is considered within the normal range, indicating that the client's malnutrition is improving due to the TPN therapy. A higher BMI suggests a better nutritional status, which is a therapeutic response to the intervention.
Choice C rationale:
BUN 25 mg/dL Blood Urea Nitrogen (BUN) levels can be affected by various factors, including hydration status, renal function, and protein intake. While BUN levels might be monitored to assess renal function and overall nutritional status, a specific BUN level of 25 mg/dL does not directly indicate a therapeutic response to TPN.
Choice D rationale:
Hgb 10 g/dL Hemoglobin (Hgb) level of 10 g/dL is within the normal range for hemoglobin levels. Adequate nutrition, as provided by TPN, can support the production of red blood cells and maintain hemoglobin levels. Therefore, an Hgb level of 10 g/dL can be considered a positive therapeutic response to TPN.