A nurse is teaching about nutrition to a client who has a new diagnosis of chronic kidney disease. Which of the following recommendations should the nurse include in the teaching?

Choice A reason: Creatinine 0.8 mg/dL is within the normal range (0.6-1.2), and it does not indicate fluid volume excess. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. High creatinine levels can indicate kidney damage or impaired renal function.

Choice B reason: Hgb 15 g/dL is within the normal range (13-17 for men, 12-16 for women), and it does not indicate fluid volume excess. Hgb stands for hemoglobin, which is a protein in red blood cells that carries oxygen to the tissues. Low hemoglobin levels can indicate anemia, bleeding, or hemolysis.

Choice C reason: BUN 18 mg/dL is within the normal range (7-20), and it does not indicate fluid volume excess. BUN stands for blood urea nitrogen, which is a waste product of protein metabolism that is filtered by the kidneys. High BUN levels can indicate dehydration, kidney damage, or high protein intake.

Choice D reason: Sodium 149 mEq/L is high and indicates fluid volume excess. Sodium is an electrolyte that helps maintain fluid balance, blood pressure, and nerve impulses. High sodium levels can cause fluid retention, edema, hypertension, and heart failure.

Choice A reason: Abdominal obesity is a risk factor for developing diabetes mellitus. Abdominal obesity, also known as central obesity or visceral fat, is the accumulation of fat around the abdomen and organs. Abdominal obesity can cause insulin resistance, inflammation, and metabolic syndrome, which are all associated with diabetes.

Choice B reason: Elevated HDL level is not a risk factor for developing diabetes mellitus. HDL stands for high-density lipoprotein, which is a type of cholesterol that carries excess cholesterol from the tissues to the liver for disposal. HDL is also known as "good" cholesterol, as it helps protect against heart disease and stroke. A high HDL level is desirable and beneficial for health.

Choice C reason: History of hypotension is not a risk factor for developing diabetes mellitus. Hypotension means low blood pressure, which is usually defined as less than 90/60 mm Hg. Hypotension can cause symptoms such as dizziness, fainting, fatigue, and blurred vision. Hypotension can be caused by dehydration, blood loss, medication side effects, or other conditions.

Choice D reason: History of hyperthyroidism is not a risk factor for developing diabetes mellitus. Hyperthyroidism means overactive thyroid gland, which produces too much thyroid hormone. Thyroid hormone regulates metabolism, growth, and development. Hyperthyroidism can cause symptoms such as weight loss, nervousness, palpitations, heat intolerance, and insomnia. Hyperthyroidism can be caused by Graves' disease, thyroid nodules, or thyroiditis.