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: Abdominal obesity is a risk factor for developing diabetes mellitus. Abdominal obesity, also known as central obesity or visceral fat, is the accumulation of fat around the abdomen and organs. Abdominal obesity can cause insulin resistance, inflammation, and metabolic syndrome, which are all associated with diabetes.

Choice B reason: Elevated HDL level is not a risk factor for developing diabetes mellitus. HDL stands for high-density lipoprotein, which is a type of cholesterol that carries excess cholesterol from the tissues to the liver for disposal. HDL is also known as "good" cholesterol, as it helps protect against heart disease and stroke. A high HDL level is desirable and beneficial for health.

Choice C reason: History of hypotension is not a risk factor for developing diabetes mellitus. Hypotension means low blood pressure, which is usually defined as less than 90/60 mm Hg. Hypotension can cause symptoms such as dizziness, fainting, fatigue, and blurred vision. Hypotension can be caused by dehydration, blood loss, medication side effects, or other conditions.

Choice D reason: History of hyperthyroidism is not a risk factor for developing diabetes mellitus. Hyperthyroidism means overactive thyroid gland, which produces too much thyroid hormone. Thyroid hormone regulates metabolism, growth, and development. Hyperthyroidism can cause symptoms such as weight loss, nervousness, palpitations, heat intolerance, and insomnia. Hyperthyroidism can be caused by Graves' disease, thyroid nodules, or thyroiditis.

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.