A nurse is providing teaching about the Dietary Approaches to Stop Hypertension (DASH) diet to a client who has hypertension. Which of the following instructions should the nurse include?

Choice A rationale:
Hyperventilation, or rapid breathing, is a potential manifestation of hyperglycemia in clients with diabetes mellitus. As blood glucose levels rise, the body attempts to eliminate excess glucose through increased urination. This can lead to dehydration and electrolyte imbalances, potentially resulting in hyperventilation as the body tries to compensate for acidosis. The increased respiratory rate is an attempt to expel carbon dioxide and normalize pH levels. Teaching the client about the connection between hyperglycemia and hyperventilation is crucial, as recognizing this symptom can prompt early intervention.
Choice B rationale:
Cool skin is not a typical manifestation of hyperglycemia. Hyperglycemia usually leads to increased blood flow and warm skin due to the vasodilatory effects of high glucose levels. Cool skin might be more indicative of poor peripheral circulation, but it's not directly related to hyperglycemia.
Choice C rationale:
Metallic taste is not a recognized manifestation of hyperglycemia. Hyperglycemia primarily affects the body's glucose metabolism and can lead to symptoms like increased thirst, frequent urination, and fatigue. Metallic taste is not directly linked to hyperglycemia and might be related to other factors.
Choice D rationale:
Anxiety can be a psychological response to the stress of a new diabetes diagnosis, but it is not a specific manifestation of hyperglycemia. Hyperglycemia-related symptoms are more physiological and metabolic in nature, involving glucose regulation and acid-base balance.

Choice A rationale:
A client whose hematocrit is 42% (Choice A) falls within the normal range for hematocrit values, which is typically around 37-52% for adult women and 40-54% for adult men. While low hematocrit values can indicate anemia, a value of 42% is not indicative of iron-deficiency anemia on its own.
Choice B rationale:
A client whose RBC count is 5.2 million/mm3 (Choice B) is within the normal range for red blood cell counts, which is roughly 4.5-5.5 million/mm3 for adult women and 4.5-6.1 million/mm3 for adult men. Although low RBC counts can be associated with anemia, the value provided is not suggestive of iron-deficiency anemia without further context.
Choice C rationale:
A client whose ferritin level is 8 ng/mL (Choice C) is the correct choice. Ferritin is a protein that stores iron, and low levels of ferritin are a strong indicator of iron-deficiency anemia. Ferritin levels less than 12 ng/mL are often considered indicative of depleted iron stores.
Choice D rationale:
A client whose hemoglobin is 15 g/dL (Choice D) falls within the normal range for hemoglobin values, which is typically around 12-15.5 g/dL for adult women and 13.5-17.5 g/dL for adult men. While low hemoglobin can suggest anemia, a value of 15 g/dL is not indicative of iron-deficiency anemia on its own.