A nurse is caring for a client who has acute kidney injury and has been prescribed total parenteral nutrition (TPN). When educating the client on the use of TPN, which of the following information should the nurse include?

Choice A reason: Abdominal distention is a possible complication of enteral nutrition, as it may indicate gas accumulation, constipation, or intolerance to the formula. However, it is not the greatest risk to the client, as it can be prevented or managed by adjusting the formula, rate, or volume of the feeding, or by administering medications or enemas.

Choice B reason: Fluid overload is a possible complication of enteral nutrition, as it may indicate excessive fluid intake, renal impairment, or heart failure. However, it is not the greatest risk to the client, as it can be prevented or managed by monitoring the fluid balance, electrolytes, and vital signs, or by administering diuretics or fluid restriction.

Choice C reason: Glycosuria is a possible complication of enteral nutrition, as it may indicate hyperglycemia, diabetes, or infection. However, it is not the greatest risk to the client, as it can be prevented or managed by monitoring the blood glucose, urine output, and signs of infection, or by administering insulin or antibiotics.

Choice D reason: Tube obstruction is the greatest risk to the client, as it may indicate clogging, kinking, or twisting of the tube, which can impair the delivery of the nutrition and medication, and cause aspiration, infection, or perforation. Tube obstruction can be prevented by flushing the tube with water before and after each feeding or medication, and by using a syringe or a pump to administer the formula. Tube obstruction can be managed by using warm water, carbonated beverages, or pancreatic enzymes to unclog the tube, or by replacing the tube if necessary.

Choice A reason: "Limit the number of fast-food meals to five each week." is not a good information to include, as it implies that fast-food meals are acceptable as long as they are not too frequent. The nurse should discourage the students from consuming fast-food meals, as they are high in fat, salt, sugar, and calories, and low in nutrients, fiber, and antioxidants. The nurse should advise the students to choose healthier options, such as fruits, vegetables, whole grains, lean proteins, and low-fat dairy products.

Choice B reason: "You should drink a glass of milk with breakfast." is a good information to include, as it promotes the intake of calcium, which is essential for bone health and growth. Adolescents need about 1,300 mg of calcium per day, which can be obtained from milk and other dairy products, such as cheese and yogurt. The nurse should encourage the students to drink milk with breakfast, as it can also provide protein, vitamin D, and other nutrients.

Choice C reason: "Most of your dietary intake should come from protein." is not a good information to include, as it suggests that protein is more important than other macronutrients, such as carbohydrates and fats. The nurse should explain to the students that protein is necessary for tissue repair, muscle development, and immune function, but it should not exceed 10 to 30 percent of the total caloric intake. The nurse should recommend the students to consume a balanced diet that includes carbohydrates, fats, and protein, as well as vitamins, minerals, and water.

Choice D reason: "Your total intake for the day should not exceed 1,000 calories." is not a good information to include, as it indicates that calorie restriction is the key to a healthy diet. The nurse should inform the students that calorie needs vary depending on age, gender, activity level, and growth rate, and that 1,000 calories is too low for most adolescents. The nurse should advise the students to eat enough calories to meet their energy and nutritional needs, and to avoid skipping meals or starving themselves.