A nurse is teaching a group of clients about dietary needs to prevent osteoporosis. Which of the following dietary choices should the nurse recommend as having the highest calcium content?

Choice A reason: Checking gastric residuals every 8 hr is not frequent enough, as it can miss signs of delayed gastric emptying, which can cause aspiration, nausea, vomiting, or abdominal distension. Gastric residuals should be checked every 4 hr.

Choice B reason: Returning gastric contents if residual is less than 250 mL is not advisable, as it can increase the risk of infection, contamination, or electrolyte imbalance. Gastric contents should be discarded if residual is more than 100 mL.

Choice C reason: Measuring the pH of gastric residual every 24 hr is not necessary, as it does not reflect the effectiveness or tolerance of the feeding. The pH of gastric residual should be checked before each feeding or every 6 to 8 hr to confirm tube placement and prevent misconnection.

Choice D reason: Flushing the tube with 15 mL of water every 4 hr is a correct action, as it can prevent clogging, maintain patency, and clear the tube of formula residue. Water should also be used to flush the tube before and after each medication administration.

Choice A reason: Hemoglobin 16 g/dL is within the normal range for adults and does not indicate an adverse effect of TPN.

Choice B reason: Temperature 36.1°C (97°F) is normal and does not indicate an infection or inflammation, which are possible complications of TPN.

Choice C reason: Blood glucose 98 mg/dL is normal and does not indicate hyperglycemia or hypoglycemia, which are common problems associated with TPN.

Choice D reason: Weight gain of 1.5 kg (3 lB. per day is excessive and indicates fluid overload, which can result from too rapid or too high infusion of TPN. Fluid overload can cause edema, hypertension, heart failure, and pulmonary congestion.