The nurse instructs a client with Type 2 diabetes mellitus (DM) to avoid refined sugar and carbohydrates. Choosing which food indicates that the client understands the diet teaching?

Choice A

Potatoes are incorrect. Potatoes are high in carbohydrates and can cause a rapid increase in blood sugar levels, so they are not the best choice for someone with diabetes trying to avoid refined sugars and carbs.

Choice B

Avocado is correct. Avocado is a good choice for someone with Type 2 diabetes who wants to avoid refined sugars and carbohydrates. Avocado is a healthy source of monounsaturated fats, fibre, and various vitamins and minerals. It has a low glycaemic index and doesn't significantly raise blood sugar levels, making it a suitable option for people with diabetes.

Choice C

Grapes is incorrect: Grapes are a fruit with natural sugars, and although they contain fibre, they can still cause spikes in blood sugar levels.

Choice D

Pretzels are incorrect. Pretzels are usually made from refined flour and are high in simple carbohydrates, causing rapid spikes in blood sugar levels. They are not a good choice for someone with diabetes aiming to avoid refined sugars and carbs.

Choice A

Urinary ketones are not most important. Monitoring urinary ketones can provide information about the utilization of glucose and fat as energy sources. However, it is not the primary lab value to monitor in TPN administration.

Choice B

Serum protein is not most important. Monitoring serum protein levels is important to assess nutritional status, but it might not be as immediate a concern as serum osmolarity.

Choice C

Serum osmolarity is the most important. When caring for a client receiving total parenteral nutrition (TPN), monitoring serum osmolarity is most important. TPN is a highly concentrated solution containing various nutrients, and it is infused directly into the bloodstream. Serum osmolarity reflects the concentration of particles (such as electrolytes, glucose, and other solutes) in the blood. Monitoring serum osmolarity is crucial to prevent complications related to fluid and electrolyte imbalances that can arise from the administration of TPN.

Choice D

Capillary glucose is not the most important. Monitoring capillary glucose levels is important, especially in clients receiving TPN with added glucose. Hyperglycaemia is a potential complication of TPN. While glucose monitoring is important, it is secondary to monitoring serum osmolarity, which encompasses a broader range of solute concentrations.