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: Dietary restrictions will not eventually allow the intake of gluten to resume. Gluten is a protein found in wheat, barley, rye, and some oats. It causes damage to the small intestine in people with celiac disease. The only treatment for celiac disease is a lifelong gluten-free diet.

Choice B reason: This condition may cause secondary lactose intolerance. Lactose is a sugar found in milk and dairy products. It is broken down by an enzyme called lactase in the small intestine. People with celiac disease may have reduced levels of lactase due to the damage to the small intestine caused by gluten. This can lead to lactose intolerance, which is the inability to digest lactose properly. Symptoms of lactose intolerance include bloating, gas, diarrhea, and abdominal pain after consuming dairy products.

Choice C reason: Nutritional therapy for this condition does not include limiting proteins and calories. People with celiac disease need adequate amounts of proteins and calories to maintain their health and prevent malnutrition. They also need to ensure that they get enough vitamins, minerals, and fiber from gluten-free sources.

Choice D reason: A normal diet cannot resume after a period of remission. Celiac disease is a chronic autoimmune disorder that does not have a cure. Even if the symptoms improve or disappear, the damage to the small intestine can still occur if gluten is consumed. Therefore, a strict gluten-free diet must be followed for life.

Choice A reason: Soaking fruits in water before peeling them is not a good practice for retaining nutrients because it can cause water-soluble vitamins, such as vitamin C and B-complex vitamins, to leach out into the water. It is better to wash fruits briefly under running water and peel them as thinly as possible.

Choice B reason: Cooking vegetables for the week and reheating them at each meal is not a good practice for retaining nutrients because it can cause nutrient losses due to exposure to heat, light, air, and water. It is better to cook vegetables as close to the time of consumption as possible and use minimal water and cooking time.

Choice C reason: Boiling vegetables on the stove until they are soft is not a good practice for retaining nutrients because it can cause significant nutrient losses due to high temperature and long cooking time. It is better to steam, microwave, or stir-fry vegetables until they are crisp-tender and retain their color and texture.

Choice D reason: Keeping ripe fruits refrigerated until eating them is a good practice for retaining nutrients because it can slow down the ripening process and prevent spoilage. Refrigeration can preserve the freshness, flavor, and nutritional value of fruits. However, some fruits, such as bananas, tomatoes, and avocados, should not be refrigerated because they can lose their quality and taste.