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Unfolding Case Study

1.
c. The Mini Nutritional Assessment is a nutritional screening tool for older clients.
2.
a. The client will need education regarding foods rich in iron to consume at home.
3.
b. Using Maslow’s hierarchy of needs framework, understanding the physical environment should be the first consideration. It is essential to understand if the client will be cooking or eating prepared meals before considering other options.
4.
d. Eating smaller portions more frequently is a strategy that can overcome decreased food intake that occurs due to getting full quickly. Although hypertension and diabetes are not risk factors for worsening anemia, decreased taste is a physiological consequence of the change in density of taste buds that occurs with aging.
5.
a. A holistic approach to client teaching includes spiritual influences, emotional influences, physical influences, and social determinants of health.
6.
b. The client’s cognitive functioning will determine if a caregiver needs to be present for the educational session.
7.
c. Ms. Foster is choosing food options and making plans for meals. She will be in the action stage of change once she begins modifying her diet.
8.
a. The nurse should recognize that change is a cyclic process and that successes and failures are expected.

Review Questions

1.
a. Vitamin K is a fat-soluble vitamin necessary for the synthesis and activation of coagulation factors II (prothrombin), VII, IX, and X.
2.
c. Folate deficiency in pregnancy can lead to macrocytic anemia in mothers and neural tube defects in fetuses.
3.
b. Long-term alcohol use can cause the malabsorption of Vitamin B12.
4.
c. These are all possible signs of scurvy, or vitamin C deficiency.
5.
c. Iron is better absorbed when taken with vitamin C, found in orange juice, and on an empty stomach.
6.
a. An older adult with anemia is likely to experience hypotension and/or lightheadedness, which is a significant risk for falls.
7.
a. Animal meat, fish, eggs, and dairy are sources of vitamin B12.
8.
a. Health literacy is the only modifiable psychosocial factor listed.
9.
a. Providing written material before determining the client’s preferred learning style, without assessing their preference and without giving time to ask questions, is not consistent with holistic nursing care.
10.
a. The nurse should consider that a change in behavior typically takes 6 months to achieve.
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