The nurse is reviewing laboratory test results for the client with liver disease and notes that the client's albumin level is low. Which nursing assessment indicates low albumin levels?

- Step 1: Identify the client's weight in pounds. The client weighs 245 lbs.

- Step 2: Convert the client's weight from pounds to kilograms. We know that 1 kg = 2.2 lbs. So, 245 lbs = 245 ÷ 2.2 kg. Calculating the division gives us approximately 111.36 kg.

- Step 3: Identify the prescribed dose in mg/kg. The client is scheduled to receive 1.5 mg/kg of enoxaparin.

- Step 4: Calculate the total dose in mg. We can do this by multiplying the client's weight in kg by the prescribed dose in mg/kg:

- Total dose = 1.5 mg/kg × 111.36 kg.

- Calculating the multiplication gives us approximately 167.04 mg.

- Step 5: Round the total dose to the nearest whole number. Rounding 167.04 gives us 167.

administer 167 mg of enoxaparin per dose.

Choice A reason: A client who works in a child care center is not typically at risk for hepatitis C unless they are exposed to blood or bodily fluids from an infected individual. Hepatitis C is primarily spread through blood-to-blood contact. While working in a child care center may increase the risk of exposure to various infections due to close contact with children, it is not a common route of transmission for hepatitis C.

Choice B reason: Eating raw shellfish is more commonly associated with hepatitis A and E, which are transmitted through the fecal-oral route, often due to contaminated food or water. Hepatitis C, however, is not typically transmitted through food or water. It is a bloodborne virus, and thus, eating raw shellfish would not be considered a high-risk activity for contracting hepatitis C.

Choice C reason: A client who has multiple tattoos is at risk for developing hepatitis C, particularly if the tattoos were done using non-sterile equipment or in an unregulated setting. The hepatitis C virus can be transmitted through the use of contaminated needles, which can occur in tattoo parlors that do not adhere to strict hygiene and sterilization practices. This is why choice C is the correct answer. While all the options presented could potentially involve some risk of infection, it is the client with multiple tattoos who is most at risk for hepatitis C, assuming the tattoos were obtained in a setting where infection control practices were not followed. It’s important for healthcare providers to assess each client’s individual risk factors and educate them on the ways to prevent hepatitis C, such as ensuring the use of sterile needles for tattoos and piercings.

Choice D reason: Traveling to an underdeveloped country may increase the risk of various infectious diseases, but hepatitis C is not commonly spread through casual contact or environmental factors. It requires blood-to-blood contact for transmission. Therefore, unless the client engaged in activities that involved such exposure, like receiving medical or dental procedures with non-sterile equipment, simply traveling to an underdeveloped country does not significantly increase the risk of contracting hepatitis C.