A nurse is evaluating a client who received intermittent IV fluids. Which of the following findings indicates the client has a fluid overload?

Choice A reason: Fructose corn syrup exacerbates irritable bowel syndrome (IBS) symptoms, as fermentable carbohydrates cause gas and bloating. IBS involves altered gut motility and microbiota, and high-fructose foods trigger visceral hypersensitivity, worsening abdominal pain and discomfort, making this an inappropriate dietary recommendation.
Choice B reason: Gluten-rich foods may worsen IBS in clients with non-celiac gluten sensitivity, causing bloating and diarrhea. Gluten disrupts gut motility in susceptible individuals, exacerbating IBS symptoms. Avoiding gluten is often advised, making increased intake counterproductive to managing IBS effectively.
Choice C reason: Milk products, containing lactose, worsen IBS in lactose-intolerant clients, causing bloating and diarrhea. Fermentable carbohydrates exacerbate gut dysmotility and visceral hypersensitivity, common in IBS, making increased dairy intake inappropriate for symptom management and dietary control in affected clients.
Choice D reason: Bran fiber, a soluble fiber, regulates bowel movements in IBS by adding bulk and stabilizing colonic transit. It reduces diarrhea and constipation, supporting microbiota health and alleviating symptoms. This evidence-based recommendation aligns with dietary management to improve gut function in IBS clients.

Choice A reason: Supplementing breastfeedings with water every 12 hours is not advised for newborns, as breast milk provides complete hydration and nutrition. Water can reduce milk intake, decreasing supply due to reduced demand. It risks electrolyte imbalances, like hyponatremia, in infants with immature kidneys. Exclusive breastfeeding for six months supports optimal growth, immune function, and maternal-infant bonding, making this recommendation inappropriate.
Choice B reason: Offering the breast at hunger cues, such as rooting or hand-sucking, supports demand-driven breastfeeding, which stimulates prolactin and oxytocin for milk production. This ensures adequate supply, promotes healthy weight gain, and aligns with the infant’s natural feeding rhythm. It prevents over- or under-feeding, fostering neonatal development and strengthening the maternal-infant bond, making this the correct advice.
Choice C reason: Limiting feeding to 10 minutes per breast can prevent adequate hindmilk transfer, which is high in fat and calories, essential for growth. Short sessions may reduce milk supply due to insufficient stimulation. Infants need variable feeding times to meet nutritional needs. This restriction risks poor weight gain and inadequate nutrition, indicating it’s not a suitable recommendation.
Choice D reason: Starting each feeding with the same breast can cause imbalanced milk production, as one breast may be understimulated, reducing overall supply. Alternating breasts ensures both are drained, supporting balanced lactation and preventing engorgement or mastitis. This practice maintains milk supply via prolactin release, making this advice incorrect for optimal breastfeeding.