A nurse is providing nutritional counseling to a client who has heart disease. The nurse should identify that which of the following client statements demonstrates an understanding of the teaching?

Choice A reason: The client should not replace salt with soy sauce, as soy sauce is not kosher. Soy sauce is made from fermented soybeans and wheat, which are not allowed in a kosher diet. The client should use kosher salt or other kosher seasonings instead.

Choice B reason: The client's primary vegetables should not be squash and corn, as they are not considered kosher. Squash and corn are classified as kitniyot, which are legumes, grains, seeds, and other plant products that are not allowed in a kosher diet. The client should eat more leafy greens, root vegetables, and fruits, which are kosher.

Choice C reason: The client can eat meat and nondairy margarine together, as they are both kosher. Nondairy margarine is made from vegetable oils, which are pareve, meaning they are neither meat nor dairy. The client should avoid eating meat and dairy products together, as they are not kosher.

Choice D reason: The client does not need to use their right hand when eating food, as this is not a requirement of a kosher diet. This is a practice of some Muslims, who believe that the right hand is for eating and the left hand is for cleaning. The client should follow the rules of kashrut, which are the Jewish laws of kosher food.

Choice A reason: Administering antiemetics following the meal is not an appropriate action for a client who is at risk for malnutrition. Antiemetics are medications that prevent or treat nausea and vomiting, which can interfere with oral intake and hydration. However, antiemetics should be given before the meal, not after, to reduce the likelihood of postprandial nausea and vomiting. ¹²

Choice B reason: Providing mouth care before feeding is an appropriate action for a client who is at risk for malnutrition. Mouth care can improve the client's appetite, taste, and comfort, as well as prevent oral infections and dental problems that can affect food intake. ³⁴

Choice C reason: Assessing for pain prior to mealtime is an appropriate action for a client who is at risk for malnutrition. Pain can reduce the client's appetite, mood, and ability to eat comfortably. The nurse should assess the client's pain level and provide adequate pain relief before offering food. ⁵⁶

Choice D reason: Removing the bedpan from the client's sight is an appropriate action for a client who is at risk for malnutrition. The presence of a bedpan or other unpleasant stimuli can cause the client to lose appetite, feel nauseated, or associate food with negative emotions. The nurse should create a pleasant and comfortable environment for the client to eat. ⁷⁸

Choice E reason: Discouraging snacks between meals is not an appropriate action for a client who is at risk for malnutrition. Snacks can provide additional calories, protein, and micronutrients that the client may not get from regular meals. Snacks can also help prevent hunger, fatigue, and hypoglycemia between meals. The nurse should encourage the client to have healthy snacks that are high in energy and nutrient density.