A nurse is recommending calcium-rich foods for a client who has an allergy to dairy products. The nurse should identify that which of the following foods contains the most calcium?

A. Apples: Apples are naturally low in phenylalanine, the amino acid that clients with phenylketonuria (PKU) cannot properly metabolize. Fruits like apples are generally safe and are encouraged in a low-phenylalanine diet because they help meet nutritional needs without contributing excess protein or phenylalanine.
B. Milk: Milk is high in protein and contains significant amounts of phenylalanine, making it unsuitable for individuals with PKU. Consuming milk can lead to elevated phenylalanine levels, which are harmful to the developing fetus and can cause cognitive impairments and developmental delays. Pregnant women with PKU must strictly avoid high-protein foods such as milk.
C. Carrots: Carrots are low in protein and phenylalanine, making them a safe and beneficial food choice for clients with PKU. They provide important nutrients like beta-carotene and fiber without compromising phenylalanine restrictions. Including vegetables like carrots supports balanced nutrition during pregnancy.
D. Coffee: Coffee itself contains minimal or no phenylalanine unless additives such as milk or cream are used. While caffeine intake should be moderated during pregnancy, plain coffee does not significantly impact phenylalanine levels and is not a food that must be avoided specifically because of PKU.

A. Elevate the head of the bed: Raising the head of the bed to at least 30 to 45 degrees is the first and most essential action to reduce the risk of aspiration during enteral feeding. This position helps ensure that the formula flows into the stomach by gravity and minimizes the potential for reflux of gastric contents into the lungs, which can lead to aspiration pneumonia.
B. Attach the barrel of the syringe to the tube after removing the plunger: This step is necessary for gravity-based enteral feeding when using a syringe. However, it should only be done after confirming tube placement and ensuring the patient is positioned properly. Attaching the syringe before proper safety precautions increases the risk of aspiration.
C. Insert air into the tube before pulling back gastric contents: Injecting air into the gastrostomy tube is part of the verification process to confirm tube placement, often followed by aspirating gastric contents. While this is important, it is not the very first action. The client's head must be elevated first to ensure safety before any manipulation of the tube begins.
D. Flush the tube with 30 mL water: Flushing is necessary to ensure tube patency and to prevent blockage before and after feedings. However, it is not the first step in the procedure. Elevating the head of the bed comes before flushing to prevent aspiration during any subsequent feeding or fluid administration.