A nurse is teaching a client who has dysphagia. Which of the following instructions should the nurse include

A. "Consume ten percent of total calories from saturated fat": The DASH diet emphasizes reducing saturated fat intake to help lower blood pressure and reduce cardiovascular risk. Saturated fat should make up less than 6% of total daily calories. Consuming 10% of total calories from saturated fat exceeds this recommendation and can contribute to hypertension and atherosclerosis.
B. "Consume foods that are high in calcium": The DASH diet promotes the intake of calcium-rich foods, especially from low-fat or fat-free dairy products. Adequate calcium intake supports healthy blood pressure by helping to regulate vascular contraction and dilation. Including calcium-rich foods such as leafy greens, fortified plant milks, and dairy is an essential component of the DASH plan.
C. "Limit sodium intake to 3,200 milligrams per day": The DASH diet recommends limiting sodium intake to no more than 2,300 milligrams per day, with a more beneficial goal of 1,500 milligrams for individuals with hypertension. A sodium limit of 3,200 milligrams per day is too high and could undermine the blood pressure-lowering benefits of the DASH diet.
D. "Increase intake of refined carbohydrates": Refined carbohydrates such as white bread, pastries, and sugary cereals are discouraged in the DASH diet. These foods can lead to blood sugar spikes and are often low in fiber and essential nutrients. Instead, the diet recommends whole grains, fruits, and vegetables that provide complex carbohydrates and fiber for better heart health.

A. "Diet sodas should not be consumed more than two or three times per week." Many diet sodas contain aspartame, which is metabolized into phenylalanine. Individuals with PKU should avoid aspartame altogether, not just limit it, to prevent harmful phenylalanine buildup.
B. "Serum bilirubin should be monitored one to two times per month during pregnancy." Bilirubin monitoring is not related to PKU management. For clients with PKU, monitoring phenylalanine levels—not bilirubin—is essential to prevent fetal complications from elevated maternal phenylalanine.
C. "Breastfeeding will prevent your baby from developing PKU." PKU is a genetic disorder. Breastfeeding does not prevent its inheritance. However, breast milk can be used cautiously under medical guidance if the infant has PKU, along with a special low-phenylalanine formula.
D. "A low-protein diet should be followed for 3 months prior to conception." Strict control of phenylalanine levels through a low-protein, low-phenylalanine diet before and during pregnancy reduces the risk of teratogenic effects on the fetus, such as microcephaly and developmental delays.