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?

The correct answer is choice D. “Adding pecans will be a change I can readily make.”

Choice A rationale: Cantaloupe is a fruit that is high in potassium. For individuals with acute kidney injury, it is important to limit potassium intake because their kidneys may not be able to effectively eliminate excess potassium from the bloodstream. Therefore, choosing cantaloupe for a snack would not indicate an understanding of the dietary restrictions necessary for managing potassium levels.

Choice B rationale: Baked potatoes are another food item that contains a significant amount of potassium. Similar to cantaloupe, consuming baked potatoes would not be advisable for someone who needs to control their potassium intake due to impaired kidney function. The client’s statement about adding baked potatoes to their diet does not reflect an understanding of the teaching provided.

Choice C rationale: Yogurt, while a nutritious food, also contains a considerable amount of potassium. For a client with acute kidney injury, eating yogurt could contribute to an undesirable increase in potassium levels, which the damaged kidneys may not be able to process efficiently. Thus, the client’s interest in eating yogurt does not demonstrate a correct understanding of the dietary guidelines given their condition.

Choice D rationale: Pecans are a low-potassium food option, making them a suitable choice for someone with acute kidney injury who needs to monitor and limit their potassium intake. The client’s willingness to add pecans to their diet indicates a proper understanding of the dietary changes necessary to manage their condition effectively. Therefore, this choice is the correct answer.

Choice A reason: Aluminum hydroxide does not primarily lower serum calcium levels. Calcium levels are typically managed in CKD patients through other medications and dietary restrictions, as hypercalcemia can occur in these patients.

Choice B reason: Aluminum hydroxide acts as a phosphate binder, which helps to lower serum phosphorus levels in patients with CKD. This is important because high phosphorus levels can lead to bone and heart problems in these patients. The normal range for serum phosphorus is approximately 2.5 to 4.5 mg/dL.

Choice C reason: Aluminum hydroxide does not have a significant effect on serum potassium levels. In CKD, potassium levels are managed through diet and other medications due to the risk of hyperkalemia, which can be life- threatening.

Choice D reason: While magaldrate contains magnesium, which could potentially worsen hypermagnesemia in CKD patients, aluminum hydroxide does not lower serum magnesium levels. Instead, it is less likely to cause elevated magnesium levels compared to magaldrate.