A nurse is teaching a client who is 24 hr postpartum about breastfeeding. Which of the following client statements indicates an understanding of the teaching?

Choice A reason: Recommending a total fiber 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 fiber is 25 g per day for women and 38 g per day for men, which can help lower cholesterol, regulate blood sugar, and promote bowel health.

Choice B reason: Referring the client to a weight-loss support group is an appropriate action for the nurse to take because it can help the client achieve and maintain a healthy weight. A body mass index (BMI) of 28 indicates overweight, which can increase the risk of chronic diseases, such as diabetes, hypertension, and cardiovascular disease. A weight-loss support group can provide education, motivation, and accountability for the client.

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 can lead to weight gain. A client who has a BMI of 28 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 worsen the health outcomes of the client.

Choice D reason: Encouraging the client to continue current daily caloric intake is not an appropriate action for the nurse to take because it may prevent weight loss. A client who has a BMI of 28 needs to reduce their caloric intake by 500 to 1,000 calories per day to lose one to two pounds per week, which is considered a safe and effective rate of weight loss.

Choice Areason: Increasing phosphorus intake is not advisable for clients with chronic kidney disease, as they may have hyperphosphatemia, a condition of high phosphorus levels in the blood. Hyperphosphatemia can cause bone loss, calcification of soft tissues, and itching.

Choice Breason: Increasing potassium intake is not advisable for clients with chronic kidney disease, as they may have hyperkalemia, a condition of high potassium levels in the blood. Hyperkalemia can cause muscle weakness, numbness, tingling, and cardiac arrest.

Choice C reason: Limiting protein intake is advisable for clients with chronic kidney disease, as protein metabolism produces urea, which is excreted by the kidneys. High protein intake can increase the workload and damage of the kidneys, and cause uremia, a condition of high urea levels in the blood. Uremia can cause nausea, vomiting, fatigue, and mental confusion.

Choice D reason: Limiting calcium intake is not advisable for clients with chronic kidney disease, as they may have hypocalcemia, a condition of low calcium levels in the blood. Hypocalcemia can cause muscle spasms, seizures, and cardiac arrhythmias.