Which older client is at greatest risk for vitamin D deficiency?

Question

1. The client on steroids for pneumonia
2. The client who is lactose intolerant
3. The client who gardens as a hobby
4. The client on phenytoin while hospitalized

Answer 1

2. The client who is lactose intolerant

Explanation: 1. Long-term steroid use is associated with vitamin D loss and bone destruction. Short-term use for an infection does not place the client at risk for deficiency.
2. Older adults at risk for poor vitamin D status include those who do not consume milk or milk products. The nurse must ensure the client is getting vitamin D and calcium from other sources such as liver.
3. Vitamin D is produced endogenously by the action of sunlight on the skin. The nurse would determine how much skin to sun exposure the client really gets each week. If the client works inside, wears thick sunscreen, and wears long coverings to garden, the client may still be at risk of vitamin D deficiency.
4. The client who is on phenytoin short-term is not at increased risk of vitamin D deficiency. Vitamin D is fat soluble and stored in the body. If the client needs phenytoin long-term there is a risk of vitamin D deficiency.