A nurse is caring for a client who is malnourished. The client states, "When I do eat, I usually just eat bread and butter to get something in me." The nurse should recognize that the client is at risk for which of the following complications?

Choice D reason: Tuna is a good source of iodine, which is a mineral that is essential for the production of thyroid hormones. A goiter is an enlargement of the thyroid gland that can be caused by iodine deficiency. Eating more iodine-rich foods, such as tuna, can help prevent or treat a goiter.

Choice A reason: Red meat is not a good source of iodine, and it can also be high in saturated fat and cholesterol, which can increase the risk of heart disease and other health problems. Eating more red meat is not advisable for a client who has a goiter.

Choice B reason: Blueberries are not a good source of iodine, and they have no direct effect on the thyroid gland or a goiter. Blueberries are rich in antioxidants and other nutrients, but they are not a specific food choice for a client who has a goiter.

Choice C reason: Bananas are not a good source of iodine, and they have no direct effect on the thyroid gland or a goiter. Bananas are a good source of potassium and fiber, but they are not a specific food choice for a client who has a goiter.

Choice A reason: Bran cereal is high in phosphorus, containing about 34% of the DV per cup (118 g) ( 1 ). Phosphorus is a mineral that helps build strong bones and teeth, but too much of it can cause problems for people with kidney disease. The kidneys normally filter out excess phosphorus from the blood, but when they are damaged, phosphorus can build up and cause bone loss, itching, and calcification of blood vessels and organs ( 2 ).

Choice B reason: A medium apple is low in phosphorus, containing only 3% of the DV per 182 g ( 3 ). Apples are also a good source of fiber, vitamin C, and antioxidants. They can help lower blood pressure, cholesterol, and blood sugar levels, which are beneficial for people with kidney disease ( 4 ).

Choice C reason: Scrambled eggs are moderate in phosphorus, containing about 12% of the DV per large egg (50 g) ( 5 ). Eggs are also high in protein, which can increase the workload of the kidneys and worsen kidney function. People with kidney disease should limit their protein intake to 0.8 g per kg of body weight per day, unless advised otherwise by their doctor ( 6 ).

Choice D reason: Ground turkey is high in phosphorus, containing about 16% of the DV per 3 oz (85 g) ( 7 ). Ground turkey is also high in protein, which can have the same negative effects as eggs on kidney function. People with kidney disease should choose lean meats and poultry, and eat them in moderation.