A nurse is caring for a client who has a nasogastric tube and is receiving a continuous tube feeding with a high-protein formula. Which of the following actions should the nurse take to prevent the tubing from clogging?

Choice A reason: Tapioca is a gluten-free food that can be recommended for a client who has celiac disease. Tapioca is a starch extracted from the cassava root, which is a tuber plant. Tapioca can be used to make puddings, breads, flours, and pearls.

Choice B reason: Barley is not a gluten-free food that can be recommended for a client who has celiac disease. Barley is a cereal grain that contains gluten, which is a protein that can trigger an immune response and damage the small intestine in people who have celiac disease. Barley should be avoided or replaced with gluten-free grains, such as rice, quinoa, or buckwheat.

Choice C reason: Cold cuts are not gluten-free foods that can be recommended for a client who has celiac disease. Cold cuts are sliced meats that are often processed and cured with additives, such as fillers, binders, and preservatives, that may contain gluten. Cold cuts should be avoided or checked for gluten-free labels before consuming.

Choice D reason: Flavored chips are not gluten-free foods that can be recommended for a client who has celiac disease. Flavored chips are snack foods that are often made from potatoes, corn, or rice, which are gluten-free ingredients, but they may also contain seasonings, spices, and sauces that may contain gluten. Flavored chips should be avoided or checked for gluten-free labels before consuming.

Choice A reason: Serum creatinine 3.5 mg/dL is high and indicates the need for further assessment. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. High creatinine levels can indicate kidney damage or impaired renal function.

Choice B reason: Hematocrit 45% is within the normal range (37-47% for women, 40-50% for men), and it does not indicate the need for further assessment. Hematocrit is the percentage of red blood cells in the blood. Low hematocrit levels can indicate anemia, bleeding, or hemolysis.

Choice C reason: Blood urea nitrogen 18 mg/dL is within the normal range (7-20), and it does not indicate the need for further assessment. Blood urea nitrogen is a waste product of protein metabolism that is filtered by the kidneys. High blood urea nitrogen levels can indicate dehydration, kidney damage, or high protein intake.

Choice D reason: Sodium 140 mEq/L is within the normal range (135-145), and it does not indicate the need for further assessment. Sodium is an electrolyte that helps maintain fluid balance, blood pressure, and nerve impulses. Low or high sodium levels can cause confusion, seizures, or coma.