A nurse is providing breakfast for a client who has celiac disease. Which of the following meal items should the nurse select?

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.

Choice A reason: Consume ten percent of total calories from saturated fat is not a correct instruction for the DASH diet. The DASH diet recommends limiting saturated fat intake to less than six percent of total calories, as saturated fat can raise blood cholesterol and increase the risk of heart disease.

Choice B reason: Consume foods that are high in calcium is a correct instruction for the DASH diet. The DASH diet emphasizes eating foods that are rich in calcium, such as low-fat dairy products, leafy green vegetables, and fortified cereals. Calcium helps regulate blood pressure and prevent osteoporosis.

Choice C reason: Increase intake of refined carbohydrates is not a correct instruction for the DASH diet. The DASH diet advises reducing intake of refined carbohydrates, such as white bread, white rice, and sweets. Refined carbohydrates can increase blood sugar and insulin levels and contribute to obesity and diabetes.

Choice D reason: Limit sodium intake to 3,200 milligrams per day is not a correct instruction for the DASH diet. The DASH diet recommends limiting sodium intake to less than 2,300 milligrams per day, or even lower to 1,500 milligrams per day for some people. Sodium can increase blood pressure and fluid retention and damage the kidneys and blood vessels.