A nurse is providing dietary teaching to a client who has a history of recurring calcium oxalate kidney stones. Which of the following instructions should the nurse include in the teaching?
 

Choice A reason: While kidney infections can cause swelling, they typically do not lead to a significant increase in abdominal girth unless associated with severe obstruction or advanced kidney disease.

Choice B reason: In PKD, the kidneys can become significantly enlarged due to the growth of numerous cysts, which

can indeed lead to an increase in abdominal girth.

Choice C reason: While stones can cause blockage and swelling, they would not typically result in a generalized increase in abdominal girth unless there is an associated infection or severe obstruction.

Choice D reason: Inflammation can lead to fluid retention, but in the context of PKD, it is the cysts' growth that primarily contributes to increased kidney size and abdominal girth.

The correct answer is choice C: "You will need to avoid rigorous exercise during the test."

Rationale:

• Choice A: The collection time for a 24-hour urine creatinine clearance test typically starts at a specific time, not necessarily with the first urine of the day.
• Choice B: A creatinine clearance test requires a 24-hour urine collection, not just 12 hours.
• Choice C: Avoiding rigorous exercise is important during the test as it can affect creatinine levels and impact the accuracy of the results.
• Choice D: Storing the urine container in a dark location is not necessary for a creatinine clearance test.