A nurse is caring for a client who reports manifestations of gastroesophageal reflux disease (GERD). Which of the following client statements should the nurse identify as a contributing factor to GERD?

Choice A rationale:
Juvenile rheumatoid arthritis is not typically associated with complications of childhood obesity. Juvenile rheumatoid arthritis is an autoimmune disorder affecting the joints, and while obesity can contribute to joint stress, it's not a commonly taught complication of obesity.
Choice B rationale:
Type 1 diabetes mellitus is not directly related to childhood obesity. Type 1 diabetes is an autoimmune condition where the body's immune system attacks and destroys insulin-producing cells in the pancreas. Obesity is more commonly associated with type 2 diabetes, as it can lead to insulin resistance over time.
Choice C rationale:
Hypothyroidism is not a well-established complication of childhood obesity. Hypothyroidism is a condition where the thyroid gland doesn't produce enough thyroid hormone, leading to a slowed metabolism. While obesity can be influenced by thyroid function, it's not a primary complication taught in relation to childhood obesity.
Choice D rationale:
Hypertension is a well-recognized complication of childhood obesity. When a child is obese, the excess adipose tissue can lead to an increase in blood pressure due to increased work that the heart must perform to supply blood to the additional tissues. This can strain the cardiovascular system and potentially lead to hypertension, which is a major risk factor for heart disease and stroke. Childhood obesity can set the stage for long-term cardiovascular issues, making hypertension a key concern.

Choice A rationale:
Cheddar cheese does not contain a significant amount of potassium. It is a dairy product that is richer in calcium and fat than in potassium.
Choice B rationale:
Raw tomato contains some potassium, but it's not as high as the other options. It's a good source of vitamins and antioxidants, but for hypokalemia, more potassium-rich options are better.
Choice C rationale:
Brown rice contains moderate levels of potassium, but it is not as high as the potassium content in a baked potato.
Choice D rationale:
One small baked potato is a great source of potassium. Potatoes are known for their high potassium content, making them suitable for individuals with hypokalemia, as potassium is essential for proper muscle and nerve function.