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Unfolding Case Study

1.
a. Although all these questions can provide information about the client’s nutrition, it is most important to identify if the client has had changes in their weight or appetite which can directly reflect her current physical health.
2.
c. The client is presenting with symptoms of hypothyroidism. Sea salt, kosher salt, and other specialty salts either do not contain iodine or contain only minimal amounts. Using iodized table salt is necessary to maintain adequate iodine intake to promote thyroid health.
3.
b. Although iodine deficiency is not the primary cause of the client’s hypothyroidism, ensuring adequate iodine intake can still be beneficial for thyroid health. Educating the client about incorporating iodine-rich foods, such as dairy products, and iodized salt into her diet can help support her thyroid function alongside her medical treatment for hypothyroidism. Seafood is another good source of iodine, but the client’s cultural background may limit the amount of seafood she consumes.
4.
a. A low-sodium diet can help manage the client’s elevated blood pressure alongside other lifestyle changes. Educating her on sodium reduction strategies, such as limiting processed foods and using herbs and spices instead of salt, will empower her to make healthier choices.
5.
a. Eating more fruits and vegetables while reducing processed food intake is a positive dietary change that supports the client’s endocrine health. This statement indicates that she has successfully incorporated the recommended changes to her diet to manage her hypothyroidism and type 2 diabetes.
6.
a. A decrease in TSH level would indicate an improvement in the client’s hypothyroidism management, while improved blood glucose control would reflect better management of her type 2 diabetes. These outcomes would demonstrate the effectiveness of the care plan in addressing her endocrine health concerns.

Review Questions

1.
c. Clients with Cushing’s syndrome should limit carbohydrate and salt intake. Increased salt intake can worsen fluid retention and weight gain. Protein intake is recommended to promote structural integrity and wound healing in these clients.
2.
a. Tuna and salmon, and other fatty fish, are good sources of vitamin D. The client should try to incorporate these foods into their diet.
3.
b. Diabetes is a condition characterized by high blood glucose levels, and a diet high in fiber and complex carbohydrates can help to regulate blood glucose levels and optimize endocrine wellness.
4.
d. Eating a diet low in processed and packaged foods helps to optimize endocrine wellness. PCOS is a condition characterized by hormonal imbalances, and a diet low in processed and packaged foods can help to optimize endocrine wellness by reducing the intake of harmful additives and stabilizing blood glucose levels.
5.
c. Hypoglycemia is characterized by low blood glucose levels, and a diet high in protein and healthy fats can help to optimize endocrine wellness by stabilizing blood glucose levels.
6.
c. Clients with Addison’s disease should increase their calcium and vitamin D intake to help decrease their risk of osteoporosis secondary to corticosteroid use.
7.
b. Assessing a client's prior knowledge of a condition and associated interventions is an appropriate method to determine their readiness to learn.
8.
c. Hemoglobin A1C is a lab test that measures how well the client’s glucose has been controlled over a 3-month period. An increased hemoglobin A1C level indicates that the client’s diet needs to be adjusted.
9.
d. Cabbage and other cruciferous vegetables can interfere with the body’s ability to use iodine.
10.
d. Unsalted nuts do not have iodized salt, making it a low-iodine food choice. Clients with hyperthyroidism need to limit their sources of iodine.
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