A nurse is evaluating a client's laboratory results. The nurse should recognize which of the following results places the client at risk for coronary heart disease.

Choice A rationale:
Obtaining the client's electrolyte levels every 4 hours is not standard practice when initiating continuous enteral feedings via a gastrostomy tube. While monitoring electrolytes is important, it's not done at such a high frequency unless there's a specific indication or concern.
Choice B rationale:
Measuring the client's gastric residual every 12 hours is a crucial action when initiating continuous enteral feedings. Gastric residual volume helps to assess the client's tolerance to the feeding, the rate of digestion and absorption, and the risk of aspiration. If the residual volume is too high, it could indicate feeding intolerance or delayed gastric emptying.

Choice Crationale:
Keeping the client's head elevated at 15 degrees during feedings is not standard practice for continuous enteral feedings. This angle could potentially promote reflux and increase the risk of aspiration. Instead, the head of the bed is usually elevated at least 30 degrees to help prevent reflux and aspiration.

Choice Drationale:
Flushing the client's tube with 30 mL of water every 4 hours is not a standard practice for continuous enteral feedings. Flushing the tube helps maintain its patency, but it's usually done before and after medication administration or as needed to prevent clogs, not on such a frequent schedule.

Choice A rationale:
Salami. Salami is a processed meat product that is typically not recommended for individuals with celiac disease. It might contain additives, preservatives, and flavorings that could potentially contain gluten or cross-contamination. While the primary concern in celiac disease is gluten, it's also important to avoid processed meats due to potential hidden sources of gluten.
Choice B rationale:
Wheat germ. Wheat germ is derived from wheat and therefore contains gluten. For individuals with celiac disease, avoiding all sources of gluten is crucial to prevent immune reactions and damage to the intestines. Recommending wheat germ to a client with celiac disease would be contradictory to their dietary needs.
Choice C rationale:
Corn. Corn is a gluten-free grain and is a safe choice for individuals with celiac disease. It is a versatile food ingredient that can be used in various forms, such as cornmeal, cornstarch, and corn flour. Corn does not contain gluten and can be included in a gluten-free diet without any adverse effects.
Choice D rationale:
Barley. Barley is a gluten-containing grain and should be avoided by individuals with celiac disease. It contains gluten proteins that can trigger immune responses and cause damage to the small intestine. Including barley in the diet of a client with celiac disease would worsen their condition and lead to gastrointestinal symptoms.