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

Choice A reason: Recommending a total fat intake of 12 g each day is not an appropriate action for the nurse to take because it is too low for most adults. The recommended dietary allowance (RDA. for fat is 20 to 35% of total calories per day, which translates to about 44 to 78 g of fat per day for an average adult who consumes 2,000 calories per day.

Choice B reason: Referring the client to a weight-loss support group is not an appropriate action for the nurse to take because the client does not need to lose weight. A body mass index (BMI) of 22 is within the normal range, which is 18.5 to 24.9. A weight-loss support group is more suitable for clients who have a BMI of 25 or higher, which indicates overweight or obesity.

Choice C reason: Advising the client to add 500 calories per day to the diet is not an appropriate action for the nurse to take because it may lead to weight gain. A client who has a BMI of 22 does not need to increase their caloric intake unless they have other medical conditions or nutritional needs that require more calories. Adding 500 calories per day to the diet can result in gaining about one pound per week, which can increase the risk of obesity and its complications.

Choice D reason: Encouraging the client to continue current daily caloric intake is an appropriate action for the nurse to take because it can help maintain a healthy weight. A client who has a BMI of 22 has a balanced energy intake and expenditure, which means that they consume enough calories to meet their metabolic needs and physical activity level. Continuing current daily caloric intake can prevent weight loss or gain and promote health and wellness.

Choice A reason: The client's creatinine level of 1.0 mg/dL is within the normal range, but it does not indicate that the treatment for benign prostatic hyperplasia has been effective. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys and excreted in urine. It reflects the kidney function, not the prostate condition.

Choice B reason: The client's urine output of 35 mL/hr is below the normal range, which is 40 to 60 mL/hr. This indicates that the client may have dehydration, kidney impairment, or urinary retention, which are complications of benign prostatic hyperplasia. A low urine output does not indicate that the treatment has been effective.

Choice C reason: The client's stool color and consistency are not related to the treatment for benign prostatic hyperplasia. Stool characteristics depend on various factors, such as diet, medication, and bowel function. A soft, brown stool does not indicate that the treatment has been effective.

Choice D reason: The client's ability to urinate without straining is a sign that the treatment for benign prostatic hyperplasia has been effective. Benign prostatic hyperplasia is a condition in which the prostate gland enlarges and compresses the urethra, causing difficulty in urination. A treatment that reduces the size of the prostate or relaxes the bladder neck muscles can improve the urine flow and reduce the straining.