The nurse is assessing the nutritional status of a group of clients in a long term care facility. Which pathophysiological process poses the highest risk for malnutrition in this population?

A. Remove the ink marks of the portal after each radiation treatment. Ink marks should not be removed, as they help ensure precise radiation targeting during each session. The marks should remain visible until the treatment plan is complete.
B. Apply moisture lotions daily to the radiation portal site. Many lotions and creams contain ingredients that can irritate the skin or interfere with radiation therapy. Only approved, non-irritating, fragrance-free moisturizers should be used, and typically only after consulting the oncology provider.
C. Protect the skin of the radiation portal site from sunlight exposure. Radiation therapy increases skin sensitivity, making it more vulnerable to sunburn and damage. Clients should cover the treated area with loose clothing or use sunscreen (SPF 30 or higher) if sun exposure is unavoidable.
D. Avoid washing the skin inside the radiation portal site. Gentle washing with mild soap and lukewarm water is recommended to keep the area clean and reduce irritation. Harsh scrubbing, hot water, and scented soaps should be avoided.

A. Explain that the child is likely to grow into her weight. This is incorrect because a BMI at the 85th percentile indicates that the child is overweight. Without intervention, the risk of continued excess weight gain and future obesity increases.
B. Obtain the child's 3-day diet history based on the mother's input. Assessing the child's dietary habits helps identify potential areas for improvement, such as reducing sugary drinks or increasing fruit and vegetable intake. Understanding the child’s nutrition is essential for developing a healthy eating plan.
C. Tell the mother that girls hit their growth spurt before boys so eating more is expected. While girls do experience growth spurts earlier than boys, this does not justify excessive weight gain. Encouraging healthy eating and physical activity is more appropriate than assuming the child will "grow out of it."
D. Inquire as to whether or not the school has a physical education program. School-based physical activity plays an important role in weight management. If the school lacks a structured program, additional strategies for physical activity should be explored.
E. Determine the child's usual physical activity pattern. Assessing the child’s activity level helps identify if sedentary behaviors (e.g., excessive screen time) are contributing to weight gain. Encouraging regular physical activity is a key part of managing childhood obesity.