A nurse is caring for a client who has end-stage kidney disease.
The client's adult child asks the nurse about becoming a living kidney donor for their parent.
Which of the following conditions in the child's medical history should the nurse identify as a contraindication to the procedure?

Choice A rationale:

Consuming foods high in bran fiber can help regulate bowel movements and alleviate symptoms of irritable bowel syndrome (IBS). Fiber adds bulk to the stool and can prevent constipation, a common symptom in IBS patients. Adequate dietary fiber intake is generally recommended for individuals with IBS.

Choice B rationale:

Increasing intake of foods high in gluten might worsen symptoms in individuals with gluten sensitivity or celiac disease. Gluten-containing foods can trigger gastrointestinal distress in susceptible individuals and should be avoided if gluten intolerance is present.

Choice C rationale:

Some individuals with IBS are lactose intolerant, which means they have difficulty digesting milk products. Increasing intake of milk products can exacerbate symptoms such as bloating, gas, and diarrhea in these individuals. It is important to assess the client's tolerance to lactose-containing foods before recommending their consumption.

Choice D rationale:

Sweetening foods with fructose corn syrup may worsen symptoms in individuals with IBS. Fructose is a type of sugar that can cause gastrointestinal distress in some people, especially those with fructose malabsorption. Recommending sweeteners with low fructose content would be more appropriate for individuals with IBS.

The correct answer is choice B: Dyspnea.

Choice B rationale: Dyspnea, or difficulty breathing, is a potential indication of a recurrent pulmonary embolism and should be reported immediately. Early detection and intervention are crucial to prevent life-threatening complications.

Choice A rationale: Hypotension may be a concerning finding in postoperative clients, but it is not the priority for a client with a history of pulmonary embolism. Hypotension could be related to various factors like bleeding or anesthesia effects.

Choice C rationale: Dry cough may occur as a result of irritation or inflammation in the airway due to the surgical procedure or anesthesia. Although it should be monitored, it is not the highest priority in this situation.

Choice D rationale: Tachycardia can be a common postoperative finding due to pain, anxiety, or other factors. Although it should be monitored and addressed, it is not the most critical concern in this case. Dyspnea is more closely related to a possible pulmonary embolism and should be reported promptly.