A nurse is providing teaching to a client who is pregnant and has phenylketonuria (PKU). Which of the following foods should the nurse instruct the client to eliminate from her diet?

Choice A rationale

While bile does play a role in digestion, it is not retained in the liver. Instead, it is produced by the liver and stored in the gallbladder. When food enters the small intestine, the gallbladder releases bile to aid in the digestion of fats. However, this process is not directly related to heartburn during pregnancy.

Choice B rationale

During pregnancy, the body produces large amounts of the hormones progesterone and relaxin. These hormones tend to relax smooth muscle tissues throughout the body, including those in the gastrointestinal (GI) tract. As a result, food sometimes moves more slowly through the system, resulting in indigestion issues of all kinds, from that bloated, gassy feeling to heartburn. This is the correct answer because increased progesterone production does indeed cause decreased motility of smooth muscle, which can lead to heartburn.

Choice C rationale

While estrogen levels do increase during pregnancy, they do not directly cause an increase in the secretion of hydrochloric acid. Instead, the relaxation of the lower esophageal sphincter due to pregnancy hormones can allow stomach acid to flow back up into the esophagus, causing heartburn.

Choice D rationale

While it is true that the growing uterus can displace the stomach, especially in later stages of pregnancy, this is not the primary cause of heartburn. Heartburn is primarily caused by the relaxation of the lower esophageal sphincter, allowing stomach acid to flow back up into the esophagus.

Choice A rationale

The client’s vital signs are within normal limits, and there is no indication of a condition that would require Prescription A based on the information provided.

Choice B rationale

The client’s vital signs are within normal limits, and there is no indication of a condition that would require Prescription B based on the information provided.

Choice C rationale

The client’s temperature is slightly elevated, which could indicate an infection or other medical condition. Prescription C might be an antibiotic or other medication to treat the suspected condition.

Choice D rationale

The client’s vital signs are within normal limits, and there is no indication of a condition that would require Prescription D based on the information provided.