A nurse is providing dietary teaching to a client who has chronic kidney disease (CKD). The nurse should instruct the client to limit which of the following nutrients? (Select all that apply.)
Potassium
Calcium
Iron
Phosphorous
Correct Answer : A,B,D
A) Potassium: CKD can lead to hyperkalemia (high potassium levels) as the kidneys lose their ability to excrete potassium effectively. Limiting potassium intake helps prevent elevated potassium levels and reduces the risk of cardiac arrhythmias.
B) Calcium: In CKD, impaired kidney function can lead to abnormalities in calcium and phosphorus metabolism, which can result in secondary hyperparathyroidism. Limiting calcium intake can help manage the imbalances in calcium and phosphorus levels.
(D) Phosphorus: Impaired kidney function in CKD leads to decreased phosphate excretion, resulting in hyperphosphatemia (high phosphorus levels). High phosphorus levels can lead to bone disease and other complications, so limiting phosphorus intake is essential.
Iron (C) is not typically limited in the diet of a client with CKD unless they have iron overload or specific conditions that warrant iron restriction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The client taking isosorbide dinitrate/hydralazine (BiDil) and experiencing a headache should be assessed first. Isosorbide dinitrate/hydralazine is a medication combination used to treat heart failure, particularly in African American patients. However, one of the side effects of hydralazine is headaches.
Headache in a client taking this medication may indicate increased blood pressure as a compensatory response to vasodilation. If not addressed promptly, it may lead to worsening heart failure or other complications. Therefore, it is essential to assess the client's blood pressure, signs of worsening heart failure, and evaluate the severity and duration of the headache.
The other options may also require attention:
A) A client taking digoxin with a potassium level of 3.1 mEq/L needs assessment, as hypokalemia can increase the risk of digoxin toxicity. However, the headache in the BiDil client takes priority due to the potential complications related to increased blood pressure.
B) A client taking captopril and experiencing a frequent nonproductive cough may indicate a side effect of the medication. While it should be assessed, it is not as immediately concerning as the headache in the BiDil client.
C) A client taking carvedilol (Coreg) with a heart rate of 58 is within an acceptable range, especially if the client is tolerating it well without symptoms. It may not require immediate assessment unless there are other concerning symptoms.
Correct Answer is ["C","E"]
Explanation
Based on the client's condition, the nurse should monitor the following:
C. Electrocardiogram (ECG) Rhythm: The client is experiencing chest pain with ST elevation, which indicates a possible myocardial infarction (MI). Continuous monitoring of the ECG rhythm is essential to identify any changes or dysrhythmias that may occur during the course of the client's care.
E. Vital signs: The client's tachycardia with ST elevation suggests cardiac involvement. Monitoring vital signs, including heart rate, blood pressure, respiratory rate, and oxygen saturation, is crucial to assess the client's hemodynamic status and detect any signs of deterioration or improvement.
The other options (A. WBC Count, B. Platelet Count, and D. Serum glucose level) are not directly related to the client's acute chest pain and the possible MI. While these tests may be ordered for other reasons or as part of the overall assessment, they are not the immediate priorities in this situation. Monitoring the ECG rhythm and vital signs are more relevant to the client's acute cardiac condition.
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