A nurse is assisting with teaching a client about the sleep-wake cycle. The nurse should include that which of the following factors can interfere with the sleep-wake cycle?

Choice A reason : Increasing intake of saturated fats is not recommended for reducing stress. Saturated fats can contribute to the development of heart disease by raising cholesterol levels and should be limited in a healthy diet.

Choice B reason : Limiting alcohol intake is generally a good practice, but specifying "3 drinks per day" is not accurate. The Dietary Guidelines for Americans recommend up to one drink per day for women and up to two drinks per day for men.

Choice C reason : Choosing complex carbohydrates each day is beneficial for managing stress. Complex carbohydrates can increase the amount of serotonin in the brain, which has a calming effect. Foods rich in complex carbohydrates include whole grains, fruits, vegetables, and legumes⁷.

Choice D reason : Consuming less than 2000 mg of sodium per day is part of a healthy diet, but it is not specifically related to stress reduction. The American Heart Association recommends no more than 2300 mg a day and moving toward an ideal limit of no more than 1500 mg per day for most adults.

Choice A reason : Applying lotion between the toes is not recommended for individuals with diabetic neuropathy. Moisture can accumulate in these areas, creating an environment conducive to fungal infections. Instead, lotion should be applied to the tops and bottoms of the feet to keep the skin moisturized and prevent cracking, but the areas between the toes should be kept dry⁵.

Choice B reason : Wearing open-toed shoes is generally not advised for patients with diabetic neuropathy. Open-toed shoes can expose the feet to injuries, which can go unnoticed due to the loss of sensation associated with neuropathy. It's important for individuals with diabetic neuropathy to wear well-fitting, closed-toed shoes that protect the feet from external injuries⁵.

Choice C reason : Washing feet in hot water is unsafe for those with diabetic neuropathy because they may not be able to accurately gauge the temperature due to reduced sensation, leading to burns. The water temperature should be warm, and individuals should always test it with their hands or a thermometer before immersing their feet⁵.

Choice D reason : Walking barefoot is risky for individuals with diabetic neuropathy because they may not feel cuts, scrapes, or other injuries due to decreased sensation in their feet. These injuries can lead to infections and ulcers if not treated promptly. Therefore, it is crucial to avoid walking barefoot and to always wear protective footwear, even indoors⁵.