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Unfolding Case Study

1.
a. Vitamin A deficiency is not associated with any of the client’s symptoms and could be ruled out based on the assessment data. Based on the findings, the health care provider orders laboratory tests to determine the client’s potassium, magnesium, and vitamin B12 levels.
2.
a. The health care provider would be expected to check the client’s iron level. Iron deficiency can cause tongue redness and inflammation and pallor. The provider decides to order a complete metabolic panel and vitamin B12, iron, and magnesium levels.
3.
d. Protein deficiency can cause weight loss, poor appetite, pallor, hair loss, and dry, brittle nails.
4.
b. Quinoa is a seed grouped with whole grain that is high in protein and is a good protein option in a vegetarian diet.
5.
d. With Crohn’s disease, and when a client has many bowel movements daily, absorption becomes a problem. In particular, iron, calcium, and vitamin D are not absorbed properly in this disease process.
6.
c. The nurse should expect supplementation to be ordered. Enteral supplementation will likely be used, but if that is not sufficient, parenteral supplementation may be considered.

Review Questions

1.
b. Digestion includes mastication, which requires the teeth to be in working condition.
2.
c. Palpating the abdomen can reveal any pain, guarding, or tenderness present in the gastrointestinal organs.
3.
b. Angular cheilitis, or fissures and crusts in the corners of the lips, can indicate vitamin B1 (thiamine), vitamin B12, or iron deficiency.
4.
c. Tofu is a plant-based protein that can be an option in a vegetarian diet.
5.
a. Edamame is a plant-based source of both protein and iron.
6.
b. Eating yogurt and other probiotic foods supports the gut’s normal microbial growth.
7.
d. Oranges have vitamin C and help create an acidic environment that increases iron absorption.
8.
b. Vitamin C assists with iron absorption and should be included in the nutritional plan.
9.
b. Ecchymosis, or bruising, is consistent with vitamin K deficiency because vitamin K is needed for adequate blood clotting.
10.
a. For vegan clients, protein options such as quinoa, tofu, and edamame are appropriate suggestions.
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