After reviewing a client's intake and output record for the last eight hours, the nurse calculates the client's current fluid balance as how many mL? (Enter numeric value only).

0730-8 oz of orange juice, hard-boiled egg, and toast

0830-voided 200 mL

0900-a cup of water

1200-1 cup of soup, tuna sandwich, and 6 ounces of apple juice

1300 vomitus of 100 mL

1400-voided 250 ml

1430-12 ounce can have carbonated beverage.

The nurse is caring for a client who is receiving total parenteral nutrition (TPN). Which finding(s) should alert the nurse that further assessment is needed? (Select all that apply.)

Choice A

Apples and blueberries are incorrect. While apples and blueberries are sources of nutrients, they are not as high in potassium as avocados and bananas.

Choice B

Avocados and bananas are correct. Chronic kidney disease (CKD) often requires dietary modifications to manage electrolyte and mineral imbalances. In CKD stage 4, the kidney's ability to filter waste and excess substances from the blood is significantly impaired. Therefore, certain foods that are high in potassium should be limited to prevent hyperkalaemia (elevated blood potassium levels).

Choice C

Cherries and cranberries are incorrect. Cherries and cranberries are also sources of nutrients, but their potassium content is not as high as that of avocados and bananas.

Choice D

Carrots and green beans are incorrect. Carrots and green beans are vegetables that are generally lower in potassium compared to fruits like avocados and bananas.

Choice A

Drinking a litre of water during and after running is not appropriate: While hydration is important, consuming plain water might not be sufficient to address electrolyte imbalances that can contribute to leg cramps. Drinking excessive amounts of water without electrolyte replacement can even lead to a dilution of electrolyte levels.

Choice B

Consuming a sports drink before and during training is appropriate. Sports drinks are formulated to provide not only hydration but also electrolytes like sodium, potassium, and sometimes magnesium. These electrolytes are important for proper muscle function and can help prevent cramps. Consuming a sports drink before and during training can help maintain electrolyte balance and reduce the risk of leg cramps.

Choice C

Eating a high carbohydrate meal after running is not appropriate. Carbohydrates are important for refuelling muscles after exercise, but this recommendation doesn't directly address the issue of leg cramps during training. Electrolytes like sodium, potassium, and magnesium play a role in muscle function and can help prevent cramps.

Choice D

Avoid drinking alcohol forty-eight hours before training is not appropriate. While avoiding alcohol before training is generally a good idea for hydration and performance reasons, it doesn't specifically address the issue of leg cramps. Electrolyte balance is more directly related to muscle cramping.