A nurse is providing teaching about a gluten-free diet to a client who has celiac disease. Which of the following foods should the nurse recommend the client include in his diet?

A) While it's important to change the feeding bag and tubing regularly to pr’vent bacterial growth and contamination, replacing them every 24 hours may not be necessary unless otherwise indicated by facility policy or if there are signs of contamination or malfunction. Routine replacement every 24 hours is not specifically indicated for preventing tubing clogging.

B) Flushing the tubing with water every 6 hours is an effective method to prevent clogging, especially when using a high-viscosity formula. Flushing helps ensure that the formula does not solidify or adhere to the inner walls of the tubing, maintaining its patency and preventing obstruction.

C) Administering the feeding by gravity drip is a method of delivery rather than a preventive measure against tubing clogging. While gravity drip administration may be appropriate for certain types of tube feedings, it does not directly address the prevention of tubing clogging.

D) Heating the formula prior to infusion may help improve its flow characteristics, especially if the formula has thickened due to being refrigerated. However, this action alone may not be sufficient to prevent tubing clogging. Flushing the tubing with water at regular intervals is a more direct and effective preventive measure in this scenario.

A) "Protein requirements decrease in times of stress": This statement is incorrect. During times of stress, such as illness or injury, the body's protein requirements often increase to support tissue repair, immune function, and other metabolic processes. Therefore, protein requirements typically increase rather than decrease during periods of stress.

B) "Glucose is broken down more slowly during times of stress": This statement is also incorrect. During stress, the body releases hormones such as cortisol and adrenaline, which promote the breakdown of glycogen into glucose, providing a quick energy source for the body's response to stress. Therefore, glucose is broken down more rapidly during times of stress to meet the increased energy demands.

C) "Acute stress causes an increase in metabolism": This statement is accurate. Acute stress triggers the release of stress hormones, such as cortisol and adrenaline, which can increase metabolism. These hormones stimulate processes such as gluconeogenesis (the production of glucose from non-carbohydrate sources), lipolysis (the breakdown of fats), and increased heart rate and blood pressure, all of which contribute to an increase in metabolic rate during acute stress.

D) "Stress causes a positive nitrogen balance in the body": This statement is incorrect. Stress, particularly severe or prolonged stress, can lead to a negative nitrogen balance in the body. During stress, there may be increased protein breakdown to provide amino acids for energy production and other metabolic needs. Additionally, stress can impair protein synthesis and utilization, leading to muscle wasting and a negative nitrogen balance.