A nurse is providing teaching about blood pressure measurement to a client who has hypertension. Which of the following instructions should the nurse include?

Choice A reason: Abdominal obesity is a risk factor for developing diabetes mellitus. Abdominal obesity, also known as central obesity or visceral fat, is the accumulation of fat around the abdomen and organs. Abdominal obesity can cause insulin resistance, inflammation, and metabolic syndrome, which are all associated with diabetes.

Choice B reason: Elevated HDL level is not a risk factor for developing diabetes mellitus. HDL stands for high-density lipoprotein, which is a type of cholesterol that carries excess cholesterol from the tissues to the liver for disposal. HDL is also known as "good" cholesterol, as it helps protect against heart disease and stroke. A high HDL level is desirable and beneficial for health.

Choice C reason: History of hypotension is not a risk factor for developing diabetes mellitus. Hypotension means low blood pressure, which is usually defined as less than 90/60 mm Hg. Hypotension can cause symptoms such as dizziness, fainting, fatigue, and blurred vision. Hypotension can be caused by dehydration, blood loss, medication side effects, or other conditions.

Choice D reason: History of hyperthyroidism is not a risk factor for developing diabetes mellitus. Hyperthyroidism means overactive thyroid gland, which produces too much thyroid hormone. Thyroid hormone regulates metabolism, growth, and development. Hyperthyroidism can cause symptoms such as weight loss, nervousness, palpitations, heat intolerance, and insomnia. Hyperthyroidism can be caused by Graves' disease, thyroid nodules, or thyroiditis.

Choice A reason: A pump is usually needed to administer intermittent tube feedings, as it can control the flow rate and volume of the formula. A pump can also prevent overfeeding, aspiration, or diarrhea.

Choice B reason: Administering feedings over 10 to 20 minutes is too fast, as it can cause abdominal cramps, nausea, vomiting, or dumping syndrome. Intermittent tube feedings should be administered over 30 to 60 minutes.

Choice C reason: Administering feedings while sleeping at night is not recommended, as it can increase the risk of aspiration, reflux, or infection. Intermittent tube feedings should be administered during waking hours and with the head of the bed elevated at least 30 degrees.

Choice D reason: Advancing the rate of feedings slowly is advisable, as it can help the body adjust to the formula and prevent intolerance or complications. The rate should be increased gradually until the desired goal is reached.