A nurse is teaching a client who has hypertension about lifestyle modifications to lower blood pressure.

Which statement by the client indicates an understanding of the teaching?

The client's serum albumin level is 4.0 g/dL.

Rationale: A serum albumin level of 4.0 g/dL indicates that the client's nutritional status is improving, as albumin is a protein that reflects the client's protein intake and nutritional status. The normal range for serum albumin levels is 3.5 to 5.0 g/dL.

Incorrect options:

B) The client's blood urea nitrogen (BUN) level is 60 mg/dL. - This finding indicates that the client's nutritional status is worsening, as BUN is a waste product of protein metabolism that accumulates in the blood due to impaired renal function. A high BUN level can indicate excessive protein intake or inadequate dialysis. The normal range for BUN levels is 10 to 20 mg/dL.

C) The client's body weight is 2 kg higher than the dry weight. - This finding indicates that the client has fluid retention, not improved nutritional status. Dry weight is the weight of the client after dialysis, when all excess fluid has been removed. A weight gain of more than 1 kg above the dry weight can indicate inadequate fluid restriction or dialysis.

D) The client's serum creatinine level is 3.0 mg/dL. - This finding indicates that the client has impaired renal function, not improved nutritional status. Creatinine is a waste product of muscle metabolism that accumulates in the blood due to reduced glomerular filtration rate (GFR). A high creatinine level can indicate decreased muscle mass or inadequate dialysis. The normal range for serum creatinine levels is 0.6 to 1.2 mg/dL.

Place the client in a negative pressure isolation room.

Rationale: Placing the client in a negative pressure isolation room is an intervention that prevents the transmission of TB to other clients and staff. Negative pressure rooms have ventilation systems that create a lower pressure inside the room than outside, causing air to flow into the room and preventing air from escaping.

Incorrect options:

B) Administer a single antitubercular medication daily. - This is an incorrect intervention, as TB requires combination therapy with multiple antitubercular medications to prevent drug resistance and ensure effective treatment. The standard regimen for TB consists of four drugs: isoniazid, rifampin, ethambutol, and pyrazinamide.

C) Obtain three consecutive sputum cultures for acid-fast bacilli (AFB). - This is an intervention that is done before the diagnosis of TB is confirmed, not after. Sputum cultures for AFB are used to identify the presence of Mycobacterium tuberculosis, the causative agent of TB. Three consecutive negative sputum cultures are required to declare the client noninfectious.

D) Instruct the client to wear a surgical mask when outside the room. - This is an incorrect intervention, as surgical masks do not provide adequate protection against TB. The client should wear a high-efficiency particulate air (HEPA) respirator when outside the room, which filters out 99.97% of airborne particles.