A nurse is reinforcing teaching with the parents of a preschool-age child who has a new diagnosis of celiac disease. Which of the following foods should the nurse recommend?

A. Wheat toast and jelly: Wheat contains gluten, which triggers an immune response in clients with celiac disease. Consuming wheat products can damage the intestinal villi and exacerbate malabsorption and gastrointestinal symptoms, making this an inappropriate choice.

B. Graham crackers with peanut butter: Graham crackers are typically made with wheat flour and contain gluten. Even paired with peanut butter, this snack is unsafe for a child with celiac disease and should be avoided to prevent intestinal injury and nutrient deficiencies.

C. Beef barley soup: Barley contains gluten and is contraindicated for clients with celiac disease. Including barley in the diet can provoke symptoms such as diarrhea, abdominal pain, and long-term intestinal damage.

D. Corn tortillas with black beans: Corn and black beans are naturally gluten-free and safe for children with celiac disease. This combination provides a balanced source of carbohydrates and protein without triggering the autoimmune response associated with gluten ingestion.

A. Document in the client's medical record every 15 min: Frequent documentation is required to monitor the client’s safety, physical and psychological status, and ongoing need for restraints. This includes checking circulation, skin integrity, respiratory status, and mental condition. Documentation every 15 minutes ensures compliance with regulatory standards and provides a detailed record of care while the client is restrained.

B. Offer toileting to the client every 4 hr: Clients in restraints should be offered toileting, hydration, and nutrition more frequently than every 4 hours, generally every 1–2 hours, to prevent complications such as skin breakdown, urinary retention, or dehydration. Waiting 4 hours is unsafe and does not meet standard restraint care guidelines.

C. Remove the restraint when the client falls asleep: Restraints should not be removed solely based on sleep. Continuous monitoring is essential, and restraints are only removed or adjusted based on the client’s behavior, safety status, and provider orders. Sleep does not automatically indicate that the client is safe to be unrestrained.

D. Request that the provider write an as-needed prescription for restraints: Restraints cannot be prescribed on an as-needed basis. They must be ordered with specific parameters including type, duration, and reason for use. Using restraints without a proper order or relying on as-needed instructions is outside legal and professional practice standards.