A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux. Which of the following instructions should the nurse include?

Choice A rationale:
Temperature 38.4°C (101.1°F) An elevated temperature could indicate an infection, which would not be a therapeutic response to total parenteral nutrition (TPN). TPN is provided to support the client's nutrition and help improve their condition; an elevated temperature might suggest ongoing illness.
Choice B rationale:
BMI 18.5 A BMI of 18.5 is considered within the normal range, indicating that the client's malnutrition is improving due to the TPN therapy. A higher BMI suggests a better nutritional status, which is a therapeutic response to the intervention.
Choice C rationale:
BUN 25 mg/dL Blood Urea Nitrogen (BUN) levels can be affected by various factors, including hydration status, renal function, and protein intake. While BUN levels might be monitored to assess renal function and overall nutritional status, a specific BUN level of 25 mg/dL does not directly indicate a therapeutic response to TPN.
Choice D rationale:
Hgb 10 g/dL Hemoglobin (Hgb) level of 10 g/dL is within the normal range for hemoglobin levels. Adequate nutrition, as provided by TPN, can support the production of red blood cells and maintain hemoglobin levels. Therefore, an Hgb level of 10 g/dL can be considered a positive therapeutic response to TPN.

Choice A rationale:
Serving foods hot might seem like a way to enhance the aroma and taste, which could be appealing to the client. However, hot foods might worsen nausea and discomfort for someone undergoing radiation therapy due to their heightened sensitivity to smells. This choice doesn't directly address the client's symptoms.
Choice B rationale:
Increasing the intake of liquids at mealtime could be helpful to prevent dehydration, but it doesn't directly address the reported symptoms of nausea, stomatitis (inflammation of the mouth), and weight loss. Moreover, certain liquids might irritate the client's throat, making this choice less suitable.
Choice C rationale:
Consuming foods high in fat content is not the ideal choice for this client. Fat-rich foods can be heavy and difficult to digest, potentially exacerbating nausea and not being well-tolerated by someone experiencing stomatitis.
Choice D rationale:
The best choice is to recommend foods high in protein. Protein is essential for tissue repair, immune function, and maintaining lean body mass. Given the client's reported weight loss and stomatitis, protein-rich foods can aid in promoting tissue healing and preventing further muscle loss. Additionally, focusing on protein sources that are easy to swallow and tolerate can address the client's discomfort while supporting their nutritional needs.