A nurse is caring for a client who is receiving continuous enteral nutrition and is experiencing diarrhea. Which of the following actions should the nurse take?

Choice A reason: Hypernatremia is not a sign of water intoxication, but rather the opposite condition. Hypernatremia means high sodium levels in the blood, which can occur when the body loses more water than sodium, such as in dehydration, diabetes insipidus, or excessive salt intake. Water intoxication causes hyponatremia, which means low sodium levels in the blood, due to excessive water intake or retention.

Choice B reason: Weak pulses are not a specific sign of water intoxication, but rather a general sign of poor perfusion or circulation. Weak pulses can have many causes, such as hypotension, shock, heart failure, or peripheral vascular disease. Water intoxication can cause hypotension, but it can also cause hypertension, depending on the volume status of the client.

Choice C reason: Muscle weakness is a sign of water intoxication, as it reflects the effect of low sodium levels on the neuromuscular system. Sodium is essential for nerve and muscle function, as it helps generate electrical impulses and contractions. When sodium levels drop too low, the nerves and muscles become less responsive and weaker. Other signs of water intoxication affecting the nervous system include confusion, headache, seizures, and coma.

Choice D reason: Exaggerated reflexes are not a sign of water intoxication, but rather a sign of hyperreflexia, which is a condition of overactive reflexes. Hyperreflexia can have many causes, such as spinal cord injury, stroke, multiple sclerosis, or electrolyte imbalance. Water intoxication can cause electrolyte imbalance, but it usually leads to hyporeflexia, which is a condition of reduced or absent reflexes.

Choice A reason: "I should use butter for cooking vegetables." is not a correct statement, as butter is high in saturated fat and cholesterol, which can increase the risk of heart disease. The nurse should advise the client to use unsaturated oils, such as olive or canola oil, for cooking vegetables.

Choice B reason: "I will choose whole grain bread." is a correct statement, as whole grains are rich in fiber, antioxidants, and phytochemicals, which can lower the risk of heart disease. The nurse should encourage the client to choose whole grain bread over refined bread, and to consume at least three servings of whole grains per day.

Choice C reason: "I should decrease my sodium intake to 3.2 grams per day." is not a correct statement, as 3.2 grams of sodium is equivalent to 8 grams of salt, which is above the recommended limit of 6 grams of salt per day for adults. The nurse should instruct the client to reduce their sodium intake to less than 2.3 grams per day, or 1.5 grams per day if they have high blood pressure, and to avoid processed foods, canned foods, and table salt.

Choice D reason: "I will eat chicken with the skin." is not a correct statement, as chicken skin is high in saturated fat and cholesterol, which can increase the risk of heart disease. The nurse should suggest the client to remove the skin from chicken before eating, and to choose lean cuts of poultry, fish, or meat.