A nurse is caring for a client who is malnourished. The client states, "When I do eat, I usually just eat bread and butter to get something in me." The nurse should recognize that the client is at risk for which of the following complications?

Choice A reason: Increased glucose levels are not a positive outcome of the client's interventions, but rather a sign of impaired glucose metabolism and insulin resistance, which can increase the risk of cardiovascular disease. The Mediterranean diet can help lower glucose levels by providing complex carbohydrates, fiber, and healthy fats, which can improve insulin sensitivity and blood sugar control.

Choice B reason: Increased HDL levels are a positive outcome of the client's interventions, as HDL stands for high-density lipoprotein, which is the "good" cholesterol that helps remove excess cholesterol from the arteries and protect against atherosclerosis and cardiovascular disease. The Mediterranean diet can help increase HDL levels by providing monounsaturated and polyunsaturated fats, such as olive oil, nuts, seeds, and fish, which can boost HDL production and function.

Choice C reason: Increased LDL levels are not a positive outcome of the client's interventions, but rather a sign of increased cholesterol deposition and inflammation in the arteries, which can lead to plaque formation and cardiovascular disease. LDL stands for low-density lipoprotein, which is the "bad" cholesterol that carries cholesterol from the liver to the cells. The Mediterranean diet can help lower LDL levels by providing antioxidants, fiber, and plant sterols, which can reduce LDL synthesis and oxidation.

Choice D reason: Increased triglyceride levels are not a positive outcome of the client's interventions, but rather a sign of increased fat storage and metabolic syndrome, which can increase the risk of cardiovascular disease. Triglycerides are a type of fat that circulates in the blood and provides energy to the cells. The Mediterranean diet can help lower triglyceride levels by providing omega-3 fatty acids, which can modulate triglyceride synthesis and breakdown.

Choice A reason: Administering the feeding by gravity drip is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Gravity drip can cause overfeeding, aspiration, and abdominal distension. The nurse should use an infusion pump to regulate the flow rate and volume of the feeding.

Choice B reason: Flushing the tubing with 10 mL water every 6 hr is an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Flushing the tubing prevents clogging, maintains patency, and hydrates the client. The nurse should also flush the tubing before and after medication administration, and whenever the feeding is interrupted or discontinued.

Choice C reason: Replacing the bag and tubing every 24 hr is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Replacing the bag and tubing every 24 hr does not prevent clogging, and may increase the risk of infection and contamination. The nurse should replace the bag and tubing every 48 hr, or as per facility policy.

Choice D reason: Heating the formula prior to infusion is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Heating the formula can alter its composition, reduce its nutritional value, and increase the risk of bacterial growth. The nurse should use room-temperature formula and store it in a refrigerator when not in use.