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 reason: Consuming ten percent of total calories from saturated fat is not a part of the DASH diet because it is too high for most adults. The DASH diet recommends consuming less than seven percent of total calories from saturated fat, which translates to about 16 g of saturated fat per day for an average adult who consumes 2,000 calories per day.

Choice B reason: Consuming foods that are high in calcium is a part of the DASH diet because it can help lower blood pressure by relaxing the blood vessels and reducing the force of contraction of the heart. The DASH diet recommends consuming 1,000 to 1,200 mg of calcium per day, which can be obtained from dairy products, leafy greens, beans, nuts, and fortified foods.

Choice C reason: Increasing intake of refined carbohydrates is not a part of the DASH diet because it can raise blood sugar and insulin levels, which can increase blood pressure and damage the blood vessels. The DASH diet recommends consuming 45 to 55 percent of total calories from carbohydrates, but mostly from whole grains, fruits, and vegetables, which are rich in fiber and antioxidants.

Choice D reason: Limiting sodium intake to 3,200 milligrams per day is not a part of the DASH diet because it is too high for most adults. The DASH diet recommends limiting sodium intake to 2,300 milligrams per day or less, which can help lower blood pressure by reducing fluid retention and vascular resistance.

Choice A reason: Alternating the first breast that is offered to the baby with each feeding can help ensure equal stimulation and drainage of both breasts, and prevent engorgement, mastitis, or milk supply problems.

Choice B reason: Storing breastmilk in the refrigerator up to 48 hours is not recommended, as it can reduce the quality and quantity of antibodies and nutrients in the milk. The optimal storage time for breastmilk in the refrigerator is up to 24 hours.

Choice C reason: Nursing the baby once every 4 hours is not sufficient, as it can lead to insufficient milk intake, dehydration, weight loss, or jaundice in the baby. The baby should be nursed on demand, or at least every 2 to 3 hours during the day and every 4 hours at night.

Choice D reason: Offering the baby water between feedings is not necessary, as it can interfere with breastfeeding and cause water intoxication or electrolyte imbalance in the baby. Breastmilk provides enough hydration and nutrition for the baby.