A nurse is caring for a client who has a pressure injury and is assessing the client's dietary intake. Which of the following factors should the nurse identify as a barrier to wound healing?

A) Breastfeeding alone cannot prevent a baby from developing phenylketonuria (PKU). PKU is an inherited metabolic disorder characterized by the body's inability to process phenylalanine, an amino acid found in protein. Infants with PKU must follow a special low-phenylalanine diet from birth to prevent intellectual disability and other complications. Breast milk contains phenylalanine, so infants with PKU require a special formula that is low in phenylalanine.

B) The consumption of diet sodas is not directly related to the management of phenylketonuria (PKU). Clients with PKU must closely monitor their intake of phenylalanine, an amino acid found in protein-containing foods. Diet sodas typically do not contain protein or phenylalanine, so their consumption is not a primary concern for individuals with PKU.

C) Monitoring serum bilirubin levels is not specific to the management of phenylketonuria (PKU) during pregnancy. Serum bilirubin levels are typically monitored to assess liver function and screen for conditions such as jaundice. While individuals with PKU may require additional monitoring during pregnancy, such as monitoring phenylalanine levels, serum bilirubin levels are not typically a focus of PKU management.

D) Following a low-protein diet for several months prior to conception is an important aspect of managing phenylketonuria (PKU) during pregnancy. High levels of phenylalanine in the mother's blood can cross the placenta and harm the developing fetus, potentially leading to intellectual disability and other complications. By adhering to a low-protein diet before conception, individuals with PKU can lower their phenylalanine levels and reduce the risk of complications during pregnancy.

A) Salami is typically not recommended for individuals with celiac disease because it often contains gluten as a filler or binder. Processed meats like salami may have additives or seasonings that contain gluten, so individuals with celiac disease should carefully read labels and choose gluten-free options.

B) Barley is a grain that contains gluten and is not suitable for individuals with celiac disease. It is commonly found in bread, cereals, soups, and other processed foods. Consuming barley can trigger adverse reactions in individuals with celiac disease due to the gluten content.

C) Corn is a suitable option for individuals with celiac disease who need to follow a gluten-free diet. Corn is naturally gluten-free and can be included in various forms, such as whole corn, cornmeal, or corn flour, in gluten-free recipes. It provides carbohydrates, fiber, vitamins, and minerals without containing gluten, making it a safe choice for those with celiac disease.

D) Wheat germ is derived from wheat, which contains gluten. Therefore, wheat germ is not appropriate for individuals with celiac disease as it can cause gluten-related symptoms. It's important for individuals with celiac disease to avoid all sources of gluten, including wheat and wheat-derived products like wheat germ.