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Unfolding Case Study

1.
c. Adequate intake of dairy products helps ensure that enough calcium is consumed, which is necessary to support musculoskeletal and integumentary growth and development in the fetus.
2.
a. Adequate intake of calcium and vitamin D is essential for developing and maintaining healthy bones and teeth in both the pregnant client and the developing fetus.
3.
a. Breastfed infants should continue vitamin D supplementation until they are taking in enough vitamin D–fortified solids or vitamin D–rich foods.
4.
a. Breastfeeding does not provide an infant with enough vitamin D. To prevent musculoskeletal disorders and to promote healthy skeletal growth, experts recommend that all infants receive vitamin D supplementation.
5.
b. The mother urgently needs to change this child’s diet so that they can achieve a healthy weight. Being overweight places additional strain on a child’s skeletal system putting them at increased risk for injury and may make them reluctant to participate in physical activity.
6.
d. Leafy green vegetables are a good source of calcium, which promotes healthy bone development in the growing child.
7.
a. Oral nutritional supplements with added protein and amino acids are recommended for clients with delayed wound healing due to malnutrition.
8.
d. Based on the findings, the MNA classifies individuals as either well-nourished, at risk for malnutrition, or malnourished.

Review Questions

1.
a. The FRAX does not diagnose osteoporosis, but it can estimate a person’s risk for a bone fracture within 10 years. This information can help the nurse and client plan care and implement strategies to help mitigate risks in the home and other environments.
2.
d. Corticosteroids, as well as antacids, proton pump inhibitors, anticonvulsants, and loop diuretics, can affect bone health with long-term use.
3.
c. Starting in infancy, parents should brush their children’s teeth at least twice a day with a fluoride toothpaste according to their dentist’s recommendations. The first dental visit should occur no later than the eruption of the first tooth, which happens well before 1 year of age in most children.
4.
d. Pruritic urticarial papules and plaques of pregnancy (PUPPP) is characterized by itchy, red, raised bumps and hives that most commonly appear on the abdomen, thighs, buttocks, and arms.
5.
c. Adolescent athletes have increased nutritional needs and should consume adequate amounts of complex carbohydrates, proteins, and fats while avoiding processed sugars.
6.
c. Food, especially calcium-rich foods, can interfere with the absorption of bisphosphonates.
7.
d. There is a correlation between low maternal vitamin D and osteopenia in newborns and decreased bone density in childhood. Consequently, it is important to monitor vitamin D levels in the pregnant client.
8.
d. Weight-bearing exercise and maintenance of a healthy weight help prevent age-related osteoporotic changes in menopausal individuals.
9.
b. Older adults with sarcopenia, or low muscle mass, should incorporate leucine-rich foods to stimulate muscle synthesis.
10.
b. Osteopenia may be present in an infant born before 30 weeks’ gestation because the majority of calcium uptake occurs during the third trimester of fetal life.
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