A hospice nurse is visiting with the son of a client who has terminal cancer. The son reports sleeping very little during the past week due to caring for his mother. Which of the following responses should the nurse make?

• A. Incorrect. While it's important to maintain social interaction with the client, avoiding excessive conversation during feeding is recommended. Distractions can interfere with the client's ability to focus on swallowing and increase the risk of aspiration.

• B. Incorrect.Coughing is a natural reflex that helps to clear the airway of any material that may have been aspirated. Discouraging coughing could potentially lead to a more serious problem.

• C. Correct.Sitting at or below the client's eye level provides a clearer view of the food and helps the client maintain control over their swallowing. This can reduce the risk of aspiration.

• D. Incorrect.Lifting the chin can actually increase the risk of aspiration by narrowing the opening to the trachea (windpipe). It's generally recommended to avoid lifting the chin during swallowing.

The nurse should discuss the following dietary recommendations with the client who has Crohn's disease:

Avoid eating fried, fatty foods and large meals: Fried and fatty foods can be difficult to digest and may worsen symptoms of diarrhea and abdominal pain. Consuming large meals can also put additional strain on the digestive system.

Limit high fiber foods, such as beans, popcorn, and seeds: High fiber foods can be challenging to digest and may exacerbate symptoms of Crohn's disease. Limiting these foods can help reduce gastrointestinal irritation and promote symptom relief.

Take a vitamin supplement daily with a meal: Crohn's disease can lead to nutrient deficiencies due to malabsorption. Taking a daily vitamin supplement with a meal can help ensure that the client receives essential nutrients and maintain overall nutritional status.

The following options are not appropriate dietary recommendations for a client with Crohn's disease:

• Drinking dairy and effervescent sodas for hydration: Dairy products can trigger symptoms in some individuals with Crohn's disease, especially if they have lactose intolerance. Effervescent sodas may contain carbonation and artificial sweeteners that can aggravate symptoms. Encouraging non-dairy sources of hydration, such as water or herbal teas, would be more appropriate.
• Enjoying fast food restaurants only if dining with friends: Fast food options are generally high in fat, sodium, and other additives that may worsen symptoms in individuals with Crohn's disease. It is advisable to limit or avoid fast food consumption altogether, regardless of whether dining alone or with others.