A nurse is providing teaching to the parents of a toddler about nutritional needs and habits. Which of the following instructions should the nurse include in the teaching?

Recommend that the client eliminate the intake of carbonated beverages: Carbonated beverages, such as soda or sparkling water, can exacerbate diarrhea symptoms by increasing gas production and potentially causing abdominal discomfort. Eliminating carbonated beverages can help alleviate symptoms and improve the client's condition.

Instruct the client to increase consumption of beans: While beans are a good source of dietary fiber and can promote regular bowel movements in some individuals, they can also worsen diarrhea in others. Since the client is experiencing chronic diarrhea, increasing consumption of beans may not be advisable as it could contribute to loose stools and increased frequency.

Provide sugar-free candy for the client between meals: Sugar-free candies often contain artificial sweeteners like sorbitol or mannitol, which can have a laxative effect and worsen diarrhea. Offering sugar-free candy may not be helpful and can potentially exacerbate the client's symptoms.

Encourage the client to drink 4 oz of milk after each loose stool: Drinking milk after each loose stool is not recommended for clients experiencing chronic diarrhea. Milk contains lactose, and some individuals may have difficulty digesting it, leading to increased gas production and loose stools. Assessing the client's tolerance to milk and considering lactose-free alternatives, if needed, would be more appropriate.

Phenylketonuria (PKU) is an inherited metabolic disorder in which the body cannot properly process an amino acid called phenylalanine. If left untreated, phenylalanine can build up to harmful levels in the body, leading to intellectual disability and other health problems. Managing PKU involves following a strict low-phenylalanine diet.

When discussing anticipatory guidance for a client with PKU who is planning a pregnancy, it is important to focus on monitoring the maternal phenylalanine levels during pregnancy. Serum bilirubin is not directly related to PKU management and would not require specific monitoring in this context.

Regarding the other options:

"Diet sodas should not be consumed more than two or three times per week": While it is generally advisable to limit the consumption of diet sodas due to their artificial sweeteners, this statement does not directly relate to PKU management or pregnancy planning.

"A low-protein diet should be followed for 3 months prior to conception": A low-protein diet is a fundamental aspect of managing PKU. However, the timeline mentioned (3 months prior to conception) is not supported by current guidelines. PKU management should be ongoing and tailored to the individual's needs, with dietary adjustments made as necessary throughout pregnancy.

"Breastfeeding will prevent your baby from developing PKU": This statement is incorrect. Breast milk naturally contains phenylalanine, which could be harmful to an infant with PKU. Infants with PKU must receive a specialized formula that is low in phenylalanine from birth. Breastfeeding is not recommended for infants with PKU unless specifically guided by a healthcare professional.