A nurse is teaching a class about dietary guidelines to promote cardiovascular health. Which of the following recommendations should the nurse include in the teaching?

Prealbumin (also known as transthyretin): Prealbumin is a protein synthesized in the liver and has a shorter half-life compared to albumin. It is considered a more sensitive marker for

short-term nutritional changes and can reflect the effectiveness of TPN within a few days.

Prealbumin levels can indicate the response to nutritional interventions and provide a more immediate assessment of nutritional adequacy.

Hemoglobin: Hemoglobin is a measure of the oxygen-carrying capacity of red blood cells and is typically used to assess anemia. While hemoglobin can be affected by nutritional status, it is not a specific marker for the short-term effectiveness of TPN.

Total albumin: Total albumin is a measure of protein status and can be affected by various factors, including inflammation and liver disease. However, it has a longer half-life and slower response to nutritional changes, so it may not be the best indicator for short-term effectiveness.

Transferrin: Transferrin is a protein involved in iron transport and can be used as an indicator of iron status. However, it may not reflect short-term changes in nutritional status and is not specific to TPN effectiveness.

Monitoring prealbumin levels can help determine the short-term effectiveness of TPN and guide adjustments to the nutritional plan.

"Eat protein at each meal": This is an important instruction for a client with dumping syndrome. Including protein at each meal can help slow down the digestion process and reduce the rapid emptying of the stomach contents into the small intestine, which is characteristic of dumping syndrome. Protein takes longer to digest and can help stabilize blood sugar levels, promote satiety, and minimize the symptoms of dumping syndrome.

"Consume three large meals daily": Consuming three large meals daily is not recommended for clients with dumping syndrome. Large meals can exacerbate the symptoms by overloading the digestive system. Instead, it is generally advised to consume smaller, more frequent meals throughout the day to help manage dumping syndrome symptoms.

"Drink beverages with meals": It is not recommended to drink beverages with meals for clients with dumping syndrome. Consuming liquids with meals can further contribute to the rapid emptying of the stomach contents and worsen symptoms. It is preferable to drink fluids between meals to maintain hydration without affecting the digestion process.

"Sit up in bed after meals": This instruction is relevant for clients with gastroesophageal reflux disease (GERD) but may not be specifically related to dumping syndrome. In the case of dumping syndrome, it is generally recommended to remain in an upright position after meals to aid digestion and reduce symptoms, such as bloating, cramping, and diarrhea.