A nurse is conducting a prenatal course about breastfeeding to a group of clients who are pregnant. Which of the following information should the nurse include?

• Preschooler unable to bear weight on legs when walking: This is a concerning physical limitation in a child of this age and suggests a possible musculoskeletal or nutritional disorder. In vitamin D deficiency, it may indicate bone pain or weakness due to poor mineralization, requiring prompt evaluation and intervention.
• Preschooler refuses all dairy products: Dairy products are a primary source of dietary calcium and often fortified with vitamin D, both essential for healthy bone development. A prolonged lack of dairy in a young child's diet can lead to nutritional deficiencies, particularly if the overall diet is limited or unbalanced.
• Legs are bowed bilaterally: Bowed legs in a preschool-aged child are a classic sign of rickets, a condition resulting from vitamin D deficiency. This skeletal deformity reflects impaired bone development and mineralization and warrants immediate medical follow-up to prevent further complications.
• Vitamin D 5 ng/mL (25 to 80 ng/mL): This level is critically low and indicates a severe vitamin D deficiency. Such a deficiency impairs calcium absorption, leading to weakened bones and increasing the risk for rickets, fractures, and long-term skeletal issues if not corrected.

A. "I should report any tingling I feel around my mouth. Tingling around the mouth, known as perioral paresthesia, is a classic symptom of hypocalcemia and can indicate worsening calcium deficiency or the onset of tetany. This symptom must be reported immediately because it suggests neuromuscular irritability that can progress to serious complications like laryngospasm or seizures if left untreated.
B. "I should take a 2,500-milligram calcium supplement every day." A daily calcium supplement of 2,500 mg exceeds the recommended upper limit for most adults, which is about 2,000 mg per day from supplements. Excessive calcium intake can lead to hypercalcemia, kidney stones, and other complications. Supplement dosage should be based on individual needs and prescribed by a healthcare provider.
C. "I should avoid dairy products, including cheese: Dairy products such as cheese, milk, and yogurt are rich sources of dietary calcium. Avoiding them would reduce calcium intake, which is counterproductive for a client with hypocalcemia. Unless contraindicated due to lactose intolerance or allergies, these foods are encouraged to help manage low calcium levels.
D. "I should expect my blood pressure to be very low." Hypocalcemia does not typically result in very low blood pressure. In fact, it more commonly causes neuromuscular symptoms such as muscle cramps, tetany, and tingling sensations. Low calcium levels may have some cardiovascular effects, but persistent hypotension is not a hallmark feature of hypocalcemia.