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 A reason: "I should use butter for cooking vegetables." is not a correct statement, as butter is high in saturated fat and cholesterol, which can increase the risk of heart disease. The nurse should advise the client to use unsaturated oils, such as olive or canola oil, for cooking vegetables.

Choice B reason: "I will choose whole grain bread." is a correct statement, as whole grains are rich in fiber, antioxidants, and phytochemicals, which can lower the risk of heart disease. The nurse should encourage the client to choose whole grain bread over refined bread, and to consume at least three servings of whole grains per day.

Choice C reason: "I should decrease my sodium intake to 3.2 grams per day." is not a correct statement, as 3.2 grams of sodium is equivalent to 8 grams of salt, which is above the recommended limit of 6 grams of salt per day for adults. The nurse should instruct the client to reduce their sodium intake to less than 2.3 grams per day, or 1.5 grams per day if they have high blood pressure, and to avoid processed foods, canned foods, and table salt.

Choice D reason: "I will eat chicken with the skin." is not a correct statement, as chicken skin is high in saturated fat and cholesterol, which can increase the risk of heart disease. The nurse should suggest the client to remove the skin from chicken before eating, and to choose lean cuts of poultry, fish, or meat.

Choice A reason: Increased cholesterol is not an indication that the weight loss program has been effective, as it is a risk factor for cardiovascular disease and stroke. The nurse should expect the client's cholesterol level to decrease as a result of the weight loss program, as it can lower the production and absorption of cholesterol in the body.

Choice B reason: Increased glycosylated hemoglobin (HbA1c) is not an indication that the weight loss program has been effective, as it is a measure of the average blood glucose level over the past 2 to 3 months. The nurse should expect the client's HbA1c level to decrease as a result of the weight loss program, as it can improve the insulin sensitivity and glucose metabolism of the body.

Choice C reason: Increased LDL (low-density lipoprotein) is not an indication that the weight loss program has been effective, as it is the "bad" cholesterol that can accumulate in the arteries and cause atherosclerosis. The nurse should expect the client's LDL level to decrease as a result of the weight loss program, as it can reduce the synthesis and secretion of LDL in the liver.

Choice D reason: Increased HDL (high-density lipoprotein) is an indication that the weight loss program has been effective, as it is the "good" cholesterol that can remove excess cholesterol from the blood and transport it to the liver for excretion. The nurse should expect the client's HDL level to increase as a result of the weight loss program, as it can enhance the activity and expression of HDL in the body.