A client is receiving continuous ambulatory peritoneal dialysis since the arteriovenous (AV) graft in the right arm is no longer available for use for hemodialysis. The client has lost weight, has increasing peripheral edema, and has a serum albumin level of 1.5 g/dL (15 g/L). Which intervention is the priority for the nurse to implement?

Serum Albumin Reference Range: 3.5 to 5.5 g/dL (35 to 55 g/L)

Choice B reason: sodium intake can be regulated by limiting canned foods in the diet. Canned foods often contain high amounts of sodium as a preservative, which can increase blood pressure and fluid retention. The nurse should advise the client to choose fresh or frozen foods instead of canned foods or rinse them before eating.

Choice C reason: salt substitutes can help with maintaining a healthy diet by reducing sodium intake. Salt substitutes are products that contain potassium chloride or other ingredients that mimic the taste of salt but have less or no sodium. The nurse should advise the client to use salt substitutes sparingly and check with their healthcare provider before using them if they have kidney problems or take certain medications.

Choice D reason: weight management is promoted by taking daily walks for thirty minutes. Being overweight or obese can increase blood pressure and strain the heart and blood vessels. The nurse should advise the client to lose weight or maintain a healthy weight by engaging in regular physical activity and eating a balanced diet.

Choice F reason: uncontrolled hypertension can lead to renal damage. High blood pressure can damage the blood vessels in the kidneys and impair their function, leading to chronic kidney disease or failure. The nurse should advise the client to monitor their blood pressure regularly and take prescribed medications as directed.

Choice A reason: alcohol consumption can produce vascular changes that increase blood pressure. Alcohol can cause vasodilation, which lowers blood pressure temporarily, but also stimulates the sympathetic nervous system, which raises blood pressure over time. The nurse should advise the client to limit alcohol intake to no more than one drink per day for women and two drinks per day for men.

Choice E reason: blood pressure readings should not be taken at noontime. Blood pressure readings should be taken at the same time each day, preferably in the morning before breakfast or in the evening before dinner, when blood pressure is usually lower and more stable. The nurse should advise the client to avoid taking blood pressure readings when they are stressed, anxious, or have just exercised or eaten.

Choice A reason: Measuring abdominal girth is not a specific assessment for a client with a suprapubic catheter, which is a tube inserted through the lower abdomen into the bladder to drain urine. However, it may be useful for monitoring fluid status and abdominal distension.

Choice B reason: Assessing perineal area is not a specific assessment for a client with a suprapubic catheter, which is a tube inserted through the lower abdomen into the bladder to drain urine. However, it may be important for maintaining hygiene and preventing infection.

Choice C reason: This is the correct answer because observing insertionsite is a specific assessment for a client with a suprapubic catheter, which is a tube inserted through the lower abdomen into the bladder to drain urine. The nurse should inspect the incision site for signs of healing, infection, or leakage.

Choice D reason: Palpating flank area is not a specific assessment for a client with a suprapubic catheter, which is a tube inserted through the lower abdomen into the bladder to drain urine. However, it may be helpful for detecting kidney tenderness or enlargement.