A nurse is providing dietary teaching to a client who has hypocalcemia due to hypoparathyroidism. Which of the following foods should the nurse recommend? (Select all that apply.)

Choice A reason:

Furosemide is a potassium-wasting diuretic that may reduce the potassium level in your blood. To counteract the loss of potassium, you should try to eat enough potassium-rich foods in your diet. Some examples of potassium-rich foods include bananas, orange juice, apricots, acorn squash, butternut squash, Hubbard squash, prunes, raisins, and bran products.

Choice B reason:

Furosemide is used to treat high blood pressure and edema by causing the kidneys to get rid of unneeded water and salt from the body into the urine. To enhance the effect of furosemide and prevent fluid retention, you should decrease intake of foods high in sodium. Some examples of sodium-rich foods include processed meats, canned soups, pickles, cheese, salted nuts, and snack foods.

Choice C reason:

Furosemide does not affect the calcium level in your blood significantly. Therefore, there is no need to increase intake of foods high in calcium when taking furosemide. However, you should still consume adequate amounts of calcium for your bone health and other functions. Some examples of calcium-rich foods include milk, yogurt, cheese, broccoli, kale, and fortified cereals.

Choice D reason:

Furosemide does not affect the protein level in your blood significantly. Therefore, there is no need to decrease intake of foods high in protein when taking furosemide. However, you should still consume moderate amounts of protein for your muscle health and other functions. Some examples of protein-rich foods include eggs, fish, poultry, meat, beans, nuts, and seeds.

Choice E reason:

Furosemide can cause dehydration and electrolyte imbalance by increasing urine output. Therefore, you should increase intake of fluids as tolerated to prevent these complications. You should drink enough water to keep your urine clear or pale yellow. You should also avoid alcohol and caffeine as they can worsen dehydration.

Choice A reason:

Hypernatremia is not a likely complication of fluid therapy for diabetic ketoacidosis (DKA) Hypernatremia occurs when there is a loss of water or an excess of sodium in the body. Fluid therapy for DKA usually involves normal saline and dextrose, which do not cause hypernatremia. In fact, fluid therapy may help correct the dehydration and hyperosmolality that are associated with DKA.

Choice B reason:

Hyperkalemia is also not a likely complication of fluid therapy for DKA. Hyperkalemia occurs when there is an excess of potassium in the blood. Fluid therapy for DKA usually involves insulin infusion, which helps lower the potassium level by driving it into the cells. Insulin also helps lower the blood glucose level and reverse the acidosis that are characteristic of DKA.

Choice C reason:

Fluid volume deficit is a common manifestation of DKA, not a complication of fluid therapy. Fluid volume deficit occurs when there is a loss of fluid and electrolytes from the body due to osmotic diuresis, vomiting, and increased respiratory rate. Fluid therapy for DKA aims to restore the fluid volume and correct the electrolyte imbalances that result from fluid loss.

Choice D reason:

Cerebral edema is a potential complication of fluid therapy for DKA, especially in children and young adults. Cerebral edema occurs when there is an increase in intracranial pressure due to swelling of the brain tissue. Fluid therapy for DKA may cause cerebral edema by altering the osmotic gradient between the blood and the brain, leading to fluid shifts into the brain cells. Cerebral edema can cause neurological symptoms such as headache, confusion, seizures, and coma.