A nurse is providing discharge teaching to the parent of a child who has a prescription for fluticasone metered-dose inhaler. Which of the following statements should the nurse include in the teaching?

Choice A reason: Encouraging a client to gain 2.3 kg (5 lb) per week is unsafe and unrealistic. Rapid weight gain increases the risk of refeeding syndrome, electrolyte imbalance, and cardiac complications. The recommended goal is gradual weight gain of about 0.5 to 1 kg per week to ensure safety and sustainability.

Choice B reason: Weighing the client once per week is insufficient. Clients with anorexia nervosa require daily weights to closely monitor progress and detect dangerous fluctuations. Weekly weighing could miss critical changes in nutritional status.

Choice C reason: Monitoring the client for 1 hr after meals is correct because individuals with anorexia nervosa may attempt to purge or exercise excessively after eating. Close observation ensures food intake is retained and prevents compensatory behaviors, supporting nutritional rehabilitation.

Choice D reason: Allowing the client to choose meal times is inappropriate because it reinforces disordered eating patterns. Structured meal times are necessary to normalize eating habits and reduce avoidance behaviors.

Choice A reason: Monitoring for abdominal ascites is essential in cirrhosis because portal hypertension and hypoalbuminemia lead to fluid accumulation in the peritoneal cavity. Ascites can cause respiratory compromise, infection risk (spontaneous bacterial peritonitis), and discomfort. Early detection allows timely interventions such as diuretics, paracentesis, or sodium restriction.

Choice B reason: A low-carbohydrate diet is not indicated in cirrhosis. Clients with cirrhosis often require adequate calories, including carbohydrates, to prevent muscle wasting and maintain energy. Restricting carbohydrates could worsen malnutrition.

Choice C reason: Reviewing serum amylase levels is more relevant to pancreatitis, not cirrhosis. Liver function is better assessed with ALT, AST, bilirubin, and albumin levels. Amylase does not provide useful information in cirrhosis management.

Choice D reason: Warm compresses may temporarily relieve pruritus, but they do not address the underlying cause, which is bile salt accumulation due to impaired liver function. More effective interventions include cholestyramine or antihistamines.