A nurse is reviewing the laboratory findings of a client who has heart failure. Which of the following findings indicates that the client is experiencing fluid volume excess?

Choice A reason: Dietary restrictions will not eventually allow the intake of gluten to resume. Gluten is a protein found in wheat, barley, rye, and some oats. It causes damage to the small intestine in people with celiac disease. The only treatment for celiac disease is a lifelong gluten-free diet.

Choice B reason: This condition may cause secondary lactose intolerance. Lactose is a sugar found in milk and dairy products. It is broken down by an enzyme called lactase in the small intestine. People with celiac disease may have reduced levels of lactase due to the damage to the small intestine caused by gluten. This can lead to lactose intolerance, which is the inability to digest lactose properly. Symptoms of lactose intolerance include bloating, gas, diarrhea, and abdominal pain after consuming dairy products.

Choice C reason: Nutritional therapy for this condition does not include limiting proteins and calories. People with celiac disease need adequate amounts of proteins and calories to maintain their health and prevent malnutrition. They also need to ensure that they get enough vitamins, minerals, and fiber from gluten-free sources.

Choice D reason: A normal diet cannot resume after a period of remission. Celiac disease is a chronic autoimmune disorder that does not have a cure. Even if the symptoms improve or disappear, the damage to the small intestine can still occur if gluten is consumed. Therefore, a strict gluten-free diet must be followed for life.

Choice A reason: Increasing vitamin C intake while taking this medication is not necessary, as vitamin C does not interact with tetracycline. Vitamin C is important for immune function, wound healing, and collagen synthesis.

Choice B reason: Eliminating raw fruits and vegetables until 2 weeks after completing this medication is not required, as raw fruits and vegetables do not interfere with tetracycline. Raw fruits and vegetables are good sources of fiber, vitamins, minerals, and antioxidants.

Choice C reason: Taking a folic acid supplement while on this medication is not advised, as folic acid can reduce the absorption and effectiveness of tetracycline. Folic acid is essential for DNA synthesis, cell division, and red blood cell production.

Choice D reason: Avoiding taking this medication with milk products is important, as milk products contain calcium, which can bind to tetracycline and form insoluble complexes that decrease its absorption and activity. Milk products also increase the risk of gastrointestinal side effects such as nausea, vomiting, and diarrhea.