The nurse is providing discharge teaching on nutritional therapy to a patient with stage 3 chronic kidney disease. Which statement by the patient suggests to the nurse that additional teaching is required?

"It's important for me to avoid foods that are high in sodium such as canned soups and processed meats."

"I should limit my intake of high-potassium foods like bananas and tomatoes."

"I will eat a high-protein diet with lots of dark green, leafy vegetables."

"I need to monitor my fluid intake to prevent fluid overload."

Answer and Explanation

The Correct Answer is C

Choice A reason: Avoiding foods that are high in sodium such as canned soups and processed meats is correct. High sodium intake can worsen fluid retention and hypertension, which are concerns in chronic kidney disease.

Choice B reason: Limiting intake of high-potassium foods like bananas and tomatoes is correct. High potassium levels can lead to dangerous cardiac arrhythmias in patients with chronic kidney disease.

Choice C reason: Eating a high-protein diet with lots of dark green, leafy vegetables is incorrect. While protein is important, excessive protein intake can increase the workload on the kidneys. Patients with chronic kidney disease often need to limit protein intake to prevent further kidney damage. Additionally, dark green, leafy vegetables are high in potassium, which should be limited.

Choice D reason: Monitoring fluid intake to prevent fluid overload is correct. Fluid overload can lead to hypertension, edema, and heart failure in patients with chronic kidney disease.

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Correct Answer is B

Explanation

Choice A reason: Acute hemolytic reactions are severe and typically present with symptoms such as fever, chills, flank pain, hemoglobinuria, and shock. The patient's mild symptoms of itching and a localized rash do not match the severe presentation of an acute hemolytic reaction.

Choice B reason: Allergic reactions to blood transfusions are common and usually present with symptoms such as itching, hives, and localized rash. The patient's vital signs and physical assessment showing mild itching and a rash on the arms are consistent with an allergic reaction.

Choice C reason: Anaphylactic reactions are severe allergic reactions that involve respiratory distress, hypotension, and shock. The patient's mild symptoms do not indicate an anaphylactic reaction.

Choice D reason: Circulatory overload presents with symptoms such as dyspnea, orthopnea, hypertension, and pulmonary edema. The patient's symptoms of itching and a rash do not align with circulatory overload.

A. pH 7.46, PaCO2 30, HCO3 24 B. pH 7.48, PaCO2 45, HCO3 29 C. pH 7.26, PaCO2 59, HCO3 30 D. pH 7.31, PaCO2 34, HCO3 18

Correct Answer is A

Explanation

Choice A reason: The lab results pH 7.46, PaCO2 30, HCO3 24 indicate respiratory alkalosis, which can occur due to hyperventilation. In pulmonary edema, the patient may hyperventilate to compensate for reduced oxygenation, leading to a decrease in carbon dioxide (PaCO2) and an increase in pH (alkaline).

Choice B reason: The lab results pH 7.48, PaCO2 45, HCO3 29 indicate metabolic alkalosis with partial compensation. This is not consistent with hyperventilation in pulmonary edema, where respiratory alkalosis is more likely.

Choice C reason: The lab results pH 7.26, PaCO2 59, HCO3 30 indicate respiratory acidosis with partial compensation. This finding suggests hypoventilation, which is not expected in a patient hyperventilating due to pulmonary edema.

Choice D reason: The lab results pH 7.31, PaCO2 34, HCO3 18 indicate metabolic acidosis with partial compensation. This is not typical in a patient with hyperventilation and pulmonary edema.

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The nurse is providing discharge teaching on nutritional therapy to a patient with stage 3 chronic kidney disease. Which statement by the patient suggests to the nurse that additional teaching is required?

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