A nurse is reinforcing nutrition teaching for a client who has chronic kidney disease about limiting foods high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply.)

Orange juice.

White rice.

Corn flakes cereal.

Watermelon.

Bananas.

Answer and Explanation

Correct Answer : A,E

The correct answer is Choice A, Choice E

Choice A rationale: Orange juice contains approximately 496 mg of potassium per 8 oz serving, making it a high-potassium beverage. In chronic kidney disease, impaired renal excretion of potassium leads to accumulation and risk of hyperkalemia. Normal serum potassium levels range from 3.5 to 5.0 mEq/L. Elevated levels can cause cardiac arrhythmias, muscle weakness, and paralysis. Avoiding potassium-rich fluids like orange juice is essential to prevent life-threatening complications in clients with reduced glomerular filtration rates.

Choice B rationale: White rice contains approximately 26 mg of potassium per 1 cup cooked, classifying it as a low-potassium food. It is safe for clients with chronic kidney disease and often recommended due to its minimal contribution to serum potassium levels. Unlike whole grains, white rice has reduced mineral content, including potassium and phosphorus. Maintaining serum potassium within the normal range of 3.5 to 5.0 mEq/L is critical, and white rice does not pose a risk of hyperkalemia.

Choice C rationale: Corn flakes cereal contains approximately 30 to 40 mg of potassium per 1 cup serving, making it a low-potassium option suitable for renal diets. It lacks the bran and whole grain components that elevate potassium content in other cereals. In chronic kidney disease, dietary potassium restriction is necessary to prevent hyperkalemia. Corn flakes do not significantly affect serum potassium levels, which should remain between 3.5 and 5.0 mEq/L to avoid neuromuscular and cardiac disturbances.

Choice D rationale: Watermelon contains approximately 112 mg of potassium per 100 grams, which is considered low to moderate. While excessive intake could contribute to potassium load, typical servings do not pose a significant risk. In chronic kidney disease, potassium restriction targets foods exceeding 200 mg per serving. Watermelon’s potassium content is below this threshold, making it generally safe when consumed in moderation. Serum potassium should be maintained within 3.5 to 5.0 mEq/L to prevent hyperkalemia.

Choice E rationale: Bananas contain approximately 422 mg of potassium per medium fruit, placing them among the highest potassium-containing fruits. In chronic kidney disease, potassium excretion is impaired, and consuming bananas can rapidly elevate serum potassium levels. Hyperkalemia increases the risk of ventricular arrhythmias and cardiac arrest. Dietary potassium restriction is essential to maintain levels within the safe range of 3.5 to 5.0 mEq/L. Therefore, bananas should be avoided to prevent life-threatening electrolyte disturbances.

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Correct Answer is D

Explanation

Choice A rationale
While alcohol consumption should generally be limited for individuals with gout, white wine is not necessarily better than red wine. Both types of wine contain purines, which can increase uric acid levels and trigger gout attacks. Therefore, the statement “I’ll drink white wine, not red” is not a correct indication of understanding a low-purine diet.
Choice B rationale
Fruits are generally low in purines and are recommended as part of a healthy diet for managing gout. Limiting fruit servings is not necessary and does not align with the principles of a low-purine diet. Therefore, the statement “I’ll limit the number of fruit servings I eat each day” is incorrect.
Choice C rationale
Red meat is high in purines and should be limited or avoided in a low-purine diet. Choosing red meat over poultry is not advisable for managing gout. Therefore, the statement “I’ll choose red meat instead of poultry” is incorrect.
Choice D rationale
Organ meats, such as liver, are very high in purines and should be eliminated from the diet to manage gout effectively. The statement “I’ll eliminate liver from my diet” correctly indicates an understanding of a low-purine diet.

A. Provide the client with a low protein diet. B. Instruct the client to cough every 4 hr. C. Advise the client to lie down after eating. D. Encourage the client to drink 8 glasses of water a day.

Correct Answer is D

Explanation

Choice A rationale
Providing a low protein diet is incorrect. Clients with COPD often require a high-protein diet to maintain muscle mass and support respiratory function. Protein is essential for the repair and maintenance of body tissues, including respiratory muscles. A low-protein diet could lead to muscle wasting and decreased respiratory function.
Choice B rationale
Instructing the client to cough every 4 hours is incorrect. Clients with COPD should be encouraged to perform controlled coughing techniques more frequently to clear secretions and prevent respiratory infections. Coughing every 4 hours may not be sufficient to maintain airway patency and prevent complications.
Choice C rationale
Advising the client to lie down after eating is incorrect. Clients with COPD should avoid lying down immediately after eating to prevent gastroesophageal reflux, which can exacerbate respiratory symptoms. Instead, they should remain upright for at least 30 minutes after meals to aid digestion and reduce the risk of aspiration.
Choice D rationale
Encouraging the client to drink 8 glasses of water a day is correct. Adequate hydration helps to thin mucus secretions, making them easier to expectorate. This can improve airway clearance and reduce the risk of respiratory infections. Additionally, staying hydrated supports overall health and well-being.

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A nurse is reinforcing nutrition teaching for a client who has chronic kidney disease about limiting foods high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply.)

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