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: "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.

Choice A reason: Diabetes mellitus is not a likely complication of malnutrition, as it is caused by insufficient insulin production or action, not by inadequate food intake. Malnutrition may worsen the outcomes of diabetes, but it does not cause it.

Choice B reason: Pressure injury is a common complication of malnutrition, as it is caused by impaired tissue perfusion and oxygenation due to poor nutrition. Malnutrition can lead to loss of muscle mass, subcutaneous fat, and skin integrity, which increase the risk of developing pressure ulcers.

Choice C reason: Heat intolerance is not a direct complication of malnutrition, as it is caused by impaired thermoregulation due to hormonal or neurological disorders, not by insufficient food intake. Malnutrition may affect the body's ability to cope with heat stress, but it does not cause it.

Choice D reason: Gastroesophageal reflux disease (GERD) is not a typical complication of malnutrition, as it is caused by the backflow of gastric contents into the esophagus due to a weak or incompetent lower esophageal sphincter, not by inadequate food intake. Malnutrition may aggravate the symptoms of GERD, but it does not cause it.