A nurse is reviewing the laboratory results of a client who has Crohn's disease and experienced an exacerbation 7 days ago. Which of the following laboratory results should the nurse identify as an indication the client is experiencing malnutrition?

Hematocrit 37%

Iron 160 mcg/dL

Prealbumin 9 mg/dL.

C-reactive protein 15 mg/L

Answer and Explanation

The Correct Answer is C

A) Hematocrit 37% is within the normal range for adults, indicating that the client’s red blood cell volume is adequate. While anemia can be a concern in clients with Crohn's disease, this value does not specifically indicate malnutrition.

B) Iron 160 mcg/dL is above the normal range (typically 50-170 mcg/dL). Elevated iron levels can result from supplementation or other factors, but it does not directly indicate malnutrition. Iron status alone is not a reliable marker for overall nutritional status.

C) Prealbumin 9 mg/dL is significantly below the normal range (15-36 mg/dL). Low prealbumin levels are a strong indicator of malnutrition because prealbumin has a short half-life and reflects recent changes in protein status and dietary intake. This result suggests the client has been experiencing inadequate nutritional intake or absorption.

D) C-reactive protein (CRP) 15 mg/L indicates inflammation, which is common during an exacerbation of Crohn's disease. While elevated CRP levels signal active inflammation, they do not specifically indicate malnutrition. CRP is more commonly used as a marker of inflammatory activity rather than nutritional status.

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Correct Answer is B

Explanation

A) Drink cold beverages to increase peristalsis: While hydration is important for overall health, drinking cold beverages specifically is not a well-supported method for increasing peristalsis. The key to avoiding constipation is adequate fluid intake, but it doesn't need to be cold.

B) Increase daily water intake: Increasing daily water intake is a fundamental and effective strategy to prevent constipation. Adequate hydration helps soften the stool, making it easier to pass and promoting regular bowel movements.

C) Take a daily laxative to soften stools: Relying on a daily laxative is not recommended for long-term management of constipation as it can lead to dependence and disrupt normal bowel function. Dietary and lifestyle changes are preferred for preventing constipation.

D) Eat a low-residue diet: A low-residue diet, which is low in fiber and roughage, is typically used for specific medical conditions and may contribute to constipation rather than prevent it. To avoid constipation, a high-fiber diet is usually recommended to promote healthy bowel movements.

A. "If you experience angina, take a 10-minute rest period, then resume exercise." B. "Stop exercising if your heart rate increases by 20 beats per minute from baseline." C. "Limit your exercise to an indoor facility to avoid exposure to the sun." D. "Begin by walking half a mile two times a day for the first week."

Correct Answer is D

Explanation

A) "If you experience angina, take a 10-minute rest period, then resume exercise."
It's important for clients to stop exercising immediately and consult a healthcare provider if they experience angina during exercise. Resting and then resuming exercise can be unsafe without medical advice, as angina indicates insufficient blood flow to the heart.

B) "Stop exercising if your heart rate increases by 20 beats per minute from baseline."
An increase in heart rate during exercise is expected, and stopping at a 20 BPM increase may be overly cautious. Clients should be taught to monitor for excessive fatigue or symptoms like dizziness, but a 20 BPM increase alone isn't necessarily a concern.

C) "Limit your exercise to an indoor facility to avoid exposure to the sun."
While excessive sun exposure can be a concern for some individuals, limiting exercise to indoors is unnecessary unless there are specific contraindications. Clients should be encouraged to exercise in environments they enjoy, with appropriate sun protection if outdoors.

D) "Begin by walking half a mile two times a day for the first week."
This recommendation is a reasonable starting point for postoperative exercise. Walking is a low-impact exercise that can help improve cardiovascular health gradually. Clients should gradually increase their activity level based on their tolerance and healthcare provider's advice.

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A nurse is reviewing the laboratory results of a client who has Crohn's disease and experienced an exacerbation 7 days ago. Which of the following laboratory results should the nurse identify as an indication the client is experiencing malnutrition?

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