A nurse is caring for a group of clients diagnosed with polycystic kidney disease (PKD). While teaching about ways to slow the progression to end-stage renal disease (ESRD), which of the following topics would be most important for the nurse to include?

Choice A reason: Decreasing the IV fluid infusion rate and limiting oral fluid intake may not be appropriate without further assessment, as the client's BUN level is elevated, which could indicate dehydration or renal impairment. The normal range for BUN is typically 7-20 mg/dL.

Choice B reason: Collecting a urine specimen for culture and sensitivity may be necessary if there is a suspicion of infection, but there is no indication of infection based solely on the provided lab values.

Choice C reason: Evaluating urine for amount and specific gravity can help assess the client's hydration status and kidney function, which is pertinent given the elevated BUN level and ongoing nausea and vomiting.

Choice D reason: Continuing routine care may not be appropriate because the BUN level is above the normal range, indicating that further assessment and intervention may be necessary.

Choice A reason: While fiber is important in a diet, recommending at least 45 g per day does not specifically address the needs of a patient with diabetic nephropathy.

Choice B reason: Consuming less than 0.8 g/kg of body weight of protein per day is recommended for patients with diabetic nephropathy to reduce the workload on the kidneys.

Choice C reason: Limiting cholesterol intake to 300 mg per day is a general recommendation for heart health but is not specific to diabetic nephropathy dietary management.

Choice D reason: The recommendation to consume less than 45% of total calories from carbohydrates is not specific to diabetic nephropathy, and carbohydrate needs can vary based on individual energy requirements.