A nurse is assisting a client who has hypertension with selecting meals. The client reports following Islamic dietary laws. Which of the following is the appropriate menu selection for this client?

A. Remove the solution from the refrigerator 1 hr before infusing: Allowing the TPN solution to warm to room temperature helps reduce the risk of vein irritation and discomfort. Cold solutions can cause venospasm or systemic reactions when infused into the bloodstream.
B. Increase the rate of the infusion as needed to keep it on schedule: TPN must be administered at a consistent prescribed rate. Increasing the rate without orders can lead to hyperglycemia, fluid overload, or metabolic complications. Any delays should be reported to the healthcare provider.
C. Weigh the client every other day: Daily weight monitoring is essential in TPN therapy to assess fluid balance and nutritional status. Weighing the client only every other day may delay the recognition of fluid overload or dehydration.
D. Change the client's TPN catheter tubing every 72 hr: TPN tubing should be changed every 24 hours to reduce the risk of catheter-related bloodstream infections. Extending beyond this time frame increases the likelihood of microbial contamination.
E. Infuse TPN through a central venous line: Due to its high glucose and osmolarity content, TPN must be administered via a central line to prevent phlebitis and allow for rapid, well-tolerated infusion. Peripheral administration is not suitable for long-term TPN.

A. "I should report any tingling I feel around my mouth. Tingling around the mouth, known as perioral paresthesia, is a classic symptom of hypocalcemia and can indicate worsening calcium deficiency or the onset of tetany. This symptom must be reported immediately because it suggests neuromuscular irritability that can progress to serious complications like laryngospasm or seizures if left untreated.
B. "I should take a 2,500-milligram calcium supplement every day." A daily calcium supplement of 2,500 mg exceeds the recommended upper limit for most adults, which is about 2,000 mg per day from supplements. Excessive calcium intake can lead to hypercalcemia, kidney stones, and other complications. Supplement dosage should be based on individual needs and prescribed by a healthcare provider.
C. "I should avoid dairy products, including cheese: Dairy products such as cheese, milk, and yogurt are rich sources of dietary calcium. Avoiding them would reduce calcium intake, which is counterproductive for a client with hypocalcemia. Unless contraindicated due to lactose intolerance or allergies, these foods are encouraged to help manage low calcium levels.
D. "I should expect my blood pressure to be very low." Hypocalcemia does not typically result in very low blood pressure. In fact, it more commonly causes neuromuscular symptoms such as muscle cramps, tetany, and tingling sensations. Low calcium levels may have some cardiovascular effects, but persistent hypotension is not a hallmark feature of hypocalcemia.