A nurse is caring for a client who has hypertension and received nutritional counseling 1 month ago. Which of the following client statements indicates the counseling was effective?

A. "I use soup broth instead of butter to flavor food.": This reflects a positive dietary change aimed at reducing saturated fat and sodium intake, both important in managing hypertension. Using broth adds flavor without the added fat and calories of butter, supporting heart health.
B. "I have started cooking most of my meals.": While home-cooked meals can promote healthier eating, the nutritional value depends on the ingredients and methods used. This statement alone does not confirm whether low-sodium or low-fat cooking practices are being followed.
C. "I eat cheese cubes and crackers as snack.": Cheese and many crackers are high in sodium and saturated fats, which can worsen hypertension. This snack choice suggests the client has not yet adopted heart-healthy dietary practices recommended during counseling.
D. "I add canned vegetables to my homemade soup.": Canned vegetables often contain high amounts of sodium unless labeled low-sodium or rinsed before use. Including them without modifications could increase salt intake and negatively affect blood pressure management.

A. Ecchymosis: Ecchymosis refers to bruising or discoloration of the skin due to bleeding under the skin. While it may indicate a bleeding tendency or trauma, it is not a common symptom associated with anaphylaxis or severe allergic reactions. This finding does not signal an immediate threat to the airway or circulatory system and does not require epinephrine administration.
B. Atopic dermatitis: Atopic dermatitis is a chronic inflammatory skin condition characterized by itching and rashes. It is often linked with allergies but is not a sign of acute anaphylaxis. The presence of atopic dermatitis suggests a predisposition to allergic conditions but does not indicate the need for emergency epinephrine treatment.
C. Double vision: Double vision, or diplopia, is a neurological symptom that may be associated with various conditions, including migraines or head injuries. It is not a classic symptom of anaphylaxis and does not indicate airway compromise or circulatory collapse. Therefore, it does not warrant epinephrine administration in this scenario.
D. Hoarseness: Hoarseness may indicate laryngeal edema, which is a sign of upper airway swelling and potential airway obstruction. In a suspected peanut allergy, this symptom is a critical warning sign of anaphylaxis. Immediate intramuscular epinephrine is required to reduce airway inflammation, improve breathing, and prevent progression to full airway obstruction or cardiovascular collapse.