A nurse is teaching about nutrition to a client who has a new diagnosis of chronic kidney disease. Which of the following recommendations should the nurse include in the teaching?

Choice A reason: Dietary restrictions will not eventually allow the intake of gluten to resume. Gluten is a protein found in wheat, barley, rye, and some oats. It causes damage to the small intestine in people with celiac disease. The only treatment for celiac disease is a lifelong gluten-free diet.

Choice B reason: This condition may cause secondary lactose intolerance. Lactose is a sugar found in milk and dairy products. It is broken down by an enzyme called lactase in the small intestine. People with celiac disease may have reduced levels of lactase due to the damage to the small intestine caused by gluten. This can lead to lactose intolerance, which is the inability to digest lactose properly. Symptoms of lactose intolerance include bloating, gas, diarrhea, and abdominal pain after consuming dairy products.

Choice C reason: Nutritional therapy for this condition does not include limiting proteins and calories. People with celiac disease need adequate amounts of proteins and calories to maintain their health and prevent malnutrition. They also need to ensure that they get enough vitamins, minerals, and fiber from gluten-free sources.

Choice D reason: A normal diet cannot resume after a period of remission. Celiac disease is a chronic autoimmune disorder that does not have a cure. Even if the symptoms improve or disappear, the damage to the small intestine can still occur if gluten is consumed. Therefore, a strict gluten-free diet must be followed for life.

Choice A reason:Raw carrots are not a good choice for a 9-month-old infant because they are also a choking hazard. Raw carrots are hard and crunchy, which can be difficult for the infant to chew and swallow. Raw carrots should be cooked until soft and cut into small pieces before offering to the infant.

Choice B reason: Unsalted popcorn is not a good choice for a 9-month-old infant because it poses a choking hazard. Popcorn is hard, dry, and irregularly shaped, which can easily get stuck in the infant's throat or airway. Popcorn should be avoided until the child is at least 4 years old.

Choice C reason: Skim milk is not a good choice for a 9-month-old infant because it does not provide enough fat and calories for their growth and development. Infants should drink breast milk or formula until they are at least 12 months old.

Choice D reason: Graham crackers are a good choice for a 9-month-old infant because they are soft, easy to chew, and provide carbohydrates and iron for their energy and growth. Graham crackers can be broken into small pieces and given to the infant as finger food.