A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux (GER). Which of the following instructions should the nurse include?

Choice A reason: Recommending a total fat intake of 12 g each day is not an appropriate action for the nurse to take because it is too low for most adults. The recommended dietary allowance (RDA. for fat is 20 to 35% of total calories per day, which translates to about 44 to 78 g of fat per day for an average adult who consumes 2,000 calories per day.

Choice B reason: Referring the client to a weight-loss support group is not an appropriate action for the nurse to take because the client does not need to lose weight. A body mass index (BMI) of 22 is within the normal range, which is 18.5 to 24.9. A weight-loss support group is more suitable for clients who have a BMI of 25 or higher, which indicates overweight or obesity.

Choice C reason: Advising the client to add 500 calories per day to the diet is not an appropriate action for the nurse to take because it may lead to weight gain. A client who has a BMI of 22 does not need to increase their caloric intake unless they have other medical conditions or nutritional needs that require more calories. Adding 500 calories per day to the diet can result in gaining about one pound per week, which can increase the risk of obesity and its complications.

Choice D reason: Encouraging the client to continue current daily caloric intake is an appropriate action for the nurse to take because it can help maintain a healthy weight. A client who has a BMI of 22 has a balanced energy intake and expenditure, which means that they consume enough calories to meet their metabolic needs and physical activity level. Continuing current daily caloric intake can prevent weight loss or gain and promote health and wellness.

Choice A reason: Navy beans and ham are good sources of potassium, which can help prevent hypokalemia, a common side effect of some diuretics. Hypokalemia can cause muscle weakness, cramps, fatigue, and cardiac arrhythmias.

Choice B reason: Cheddar cheese is high in sodium, which can cause fluid retention and increase blood pressure. Sodium intake should be limited when taking diuretics, as they can also cause hyponatremia, a condition of low sodium levels in the blood.

Choice C reason: Beef broth is also high in sodium, which can have the same effects as cheddar cheese. In addition, beef broth is high in purines, which can increase uric acid levels and cause gout, another possible side effect of some diuretics.

Choice D reason: Baked potato is high in carbohydrates, which can raise blood glucose levels and worsen diabetes, a risk factor for hypertension. Some diuretics can also cause hyperglycemia, a condition of high blood glucose levels in the blood.