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: The standard DASH diet limits sodium intake to 2,300 milligrams per day, which is about the amount of sodium in 1 teaspoon of table salt¹. A lower sodium version of DASH restricts sodium to 1,500 milligrams per day, which may lower blood pressure even further¹. Therefore, limiting sodium intake to 3,200 milligrams per day is not consistent with the DASH diet.

Choice B reason: The DASH diet recommends eating fewer refined carbohydrates and less sugar, as they can increase blood pressure and cholesterol levels². Instead, the DASH diet emphasizes eating more whole grains, fruits, and vegetables, which are rich in fiber, potassium, calcium, and magnesium².

Choice C reason: The DASH diet encourages consuming foods that are high in calcium, such as fat-free or low-fat dairy products, fish, beans, and nuts¹. Calcium is a mineral that helps regulate blood pressure and supports bone health³. Studies have shown that increasing calcium intake can lower blood pressure in people with hypertension³.

Choice D reason: The DASH diet advises limiting foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils¹. Saturated fat can raise blood pressure and cholesterol levels, which can increase the risk of heart disease and stroke. The DASH diet recommends consuming no more than six percent of total calories from saturated fat¹.

Choice A reason: Decreased fat intake is not a barrier to wound healing, as long as the client meets the recommended daily intake of essential fatty acids. Fat is important for cell membrane integrity, inflammation, and immune function. However, excessive fat intake can increase the risk of obesity, diabetes, and cardiovascular disease, which can impair wound healing.

Choice B reason: Decreased vitamin C intake is a barrier to wound healing, as vitamin C is essential for collagen synthesis, wound repair, and antioxidant activity. Vitamin C deficiency can lead to impaired wound healing, increased susceptibility to infection, and scurvy. The nurse should encourage the client to consume foods rich in vitamin C, such as citrus fruits, berries, peppers, broccoli, and tomatoes.

Choice C reason: Increased protein intake is not a barrier to wound healing, but rather a facilitator of wound healing, as protein is necessary for tissue growth, repair, and maintenance. Protein deficiency can result in delayed wound healing, increased risk of infection, and loss of lean body mass. The nurse should advise the client to consume adequate amounts of high-quality protein, such as eggs, milk, cheese, meat, fish, poultry, soy, and nuts.

Choice D reason: Increased caloric intake is not a barrier to wound healing, but rather a facilitator of wound healing, as calories provide energy for wound healing processes. Caloric deficiency can lead to malnutrition, weight loss, and impaired wound healing. The nurse should ensure that the client meets their caloric needs based on their age, weight, activity level, and wound severity.