A nurse is feeding a client who has heart failure. Which of the following findings indicates that the client is gaining fluid volume excess?

Choice A reason: Scrambled eggs are a good food choice for a client who has difficulty chewing due to ill-fitting dentures because they are soft, moist, and easy to swallow. Scrambled eggs also provide protein, iron, and vitamin B12 for the client.

Choice B reason: Tuna fish is not a good food choice for a client who has difficulty chewing due to ill-fitting dentures because it may contain bones, skin, or scales that can cause discomfort or injury to the gums or mouth. Tuna fish should be avoided or checked for bones and skin before consuming.

Choice C reason: Roast beef is not a good food choice for a client who has difficulty chewing due to ill-fitting dentures because it is tough, dry, and hard to chew. Roast beef can cause pain, fatigue, or choking for the client who has ill-fitting dentures. Roast beef should be avoided or cut into very small pieces and moistened with gravy or sauce before consuming.

Choice D reason: Apple slices are not a good food choice for a client who has difficulty chewing due to ill-fitting dentures because they are crisp, firm, and sticky. Apple slices can dislodge or damage the dentures or cause irritation or infection to the gums or mouth. Apple slices should be avoided or cooked until soft and mashed before consuming.

Choice E reason: Dried fruit is not a good food choice for a client who has difficulty chewing due to ill-fitting dentures because they are chewy, sticky, and sugary. Dried fruit can adhere to the dentures or teeth and cause dental caries or gum disease. Dried fruit should be avoided or soaked in water until soft and cut into small pieces before consuming.

Choice A reason: Dietary restrictions will not eventually allow the intake of gluten to resume. Gluten is a protein found in wheat, barley, rye, and some oats. It causes damage to the small intestine in people with celiac disease. The only treatment for celiac disease is a lifelong gluten-free diet.

Choice B reason: This condition may cause secondary lactose intolerance. Lactose is a sugar found in milk and dairy products. It is broken down by an enzyme called lactase in the small intestine. People with celiac disease may have reduced levels of lactase due to the damage to the small intestine caused by gluten. This can lead to lactose intolerance, which is the inability to digest lactose properly. Symptoms of lactose intolerance include bloating, gas, diarrhea, and abdominal pain after consuming dairy products.

Choice C reason: Nutritional therapy for this condition does not include limiting proteins and calories. People with celiac disease need adequate amounts of proteins and calories to maintain their health and prevent malnutrition. They also need to ensure that they get enough vitamins, minerals, and fiber from gluten-free sources.

Choice D reason: A normal diet cannot resume after a period of remission. Celiac disease is a chronic autoimmune disorder that does not have a cure. Even if the symptoms improve or disappear, the damage to the small intestine can still occur if gluten is consumed. Therefore, a strict gluten-free diet must be followed for life.