The nurse is visiting an older adult client who is homebound. Which finding about the client's nutritional status requires additional follow- up?

A. Continues to take a prescribed vitamin D supplement. Vitamin D supplementation is recommended for older adults to support bone health and calcium absorption. This does not require additional follow-up.
B. Usually eats an additional serving of protein-rich foods daily. Adequate protein intake is essential for muscle maintenance and overall health in older adults. This is a positive nutritional habit and does not indicate a concern.
C. Takes 1200 mg of an over-the-counter calcium supplement daily. This is within the recommended daily intake for older adults (1,000-1,200 mg/day) to maintain bone health. Excess calcium intake should be monitored, but this amount alone does not require urgent follow-up.
D. Ate approximately 1,200 calories daily for the past two weeks. Older adults typically need at least 1,500-2,000 calories per day, depending on activity level and health conditions. A prolonged intake of only 1,200 calories per day may indicate malnutrition, unintentional weight loss, or inadequate nutrient intake, requiring further evaluation.

A. Immediate allergic reaction mediated by sensitized mast cells. This describes a Type I hypersensitivity reaction, which is an immediate allergic reaction. It involves IgE antibodies and mast cell degranulation, leading to symptoms such as hives, anaphylaxis, and respiratory distress. Latex allergies can involve Type I reactions, but delayed hypersensitivity is a Type IV reaction.
B. Antigen-antibody complexes deposit in tissues activating inflammation. This describes a Type III hypersensitivity reaction, which involves immune complex deposition leading to inflammation, as seen in lupus or serum sickness. Latex allergies do not involve immune complex deposition.
C. T-cells sensitization initiates the macrophage release of cytokines causing a delayed reaction. This describes a Type IV hypersensitivity reaction, which is a delayed-type hypersensitivity (DTH) mediated by T-cells rather than antibodies. In latex-induced delayed hypersensitivity, T-cells recognize latex proteins and release cytokines, leading to localized skin inflammation, rash, and itching, typically 24–48 hours after exposure.
D. Antibodies are formed against antigens on cell surfaces. This describes a Type II hypersensitivity reaction, which involves antibody-mediated destruction of cells, as seen in hemolytic anemia or blood transfusion reactions. Latex allergies do not involve direct antibody attack on cells.