The nurse on a urology unit is caring for a client diagnosed with calcium oxalate renal calculi.
When planning this client's health education, what nutritional guidelines should the nurse provide?
Increase purine-rich food intake.
Follow a low-calcium diet.
Increase intake of potassium-rich foods.
Restrict foods with protein.
The Correct Answer is D
Protein intake can increase the excretion of calcium and oxalate in the urine, which can promote the formation of calcium oxalate stones. The client should limit animal protein sources, such as meat, poultry, fish, eggs, and dairy products.
Choice A is wrong because purine-rich foods, such as organ meats, shellfish, and beer, can increase the production of uric acid, which can cause uric acid stones.
Choice B is wrong because a low-calcium diet can increase the absorption of oxalate in the intestine, which can increase the risk of calcium oxalate stones.
The client should consume a moderate amount of calcium from dietary sources, such as milk, cheese, yogurt, and green leafy vegetables.
Choice C is wrong because potassium-rich foods, such as bananas, oranges, potatoes, and tomatoes, can help prevent calcium oxalate stones by increasing the urinary pH and citrate levels.
The client should consume adequate amounts of potassium from dietary sources.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Dysuria, which means pain or a burning sensation when peeing, is a common symptom of urinary tract infection (UTI).
UTIs are caused by bacteria entering the urinary tract through the urethra and spreading to the bladder or kidneys.
Choice A is wrong because nausea is not a specific symptom of UTI, although it may occur if the infection spreads to the kidneys.
Choice B is wrong because diarrhea is not a symptom of UTI, but rather a condition that affects the digestive system.
Choice D is wrong because constipation is also not a symptom of UTI, but a problem with bowel movements.
Normal ranges for urine tests vary depending on the type of test and the laboratory that performs it.
However, some general ranges are:
Specific gravity: 1.005 to 1.030
pH: 4.6 to 8.0
Protein: less than 150 mg/dL Glucose: less than 130 mg/dL Ketones: none
Blood: none Nitrites: none
Leukocyte esterase: none Bacteria: none or few
White blood cells: less than 5 per high-power field Red blood cells: less than 3 per high-power field Epithelial cells: few
Correct Answer is D
Explanation
Monitoring the client’s electrolyte levels before and after the treatment. This is because acute kidney injury (AKI) can cause electrolyte imbalances such as hyperkalemia, hyperphosphatemia, hypocalcemia, and metabolic acidosis. Hemodialysis can help correct these imbalances by removing excess fluid and waste products from the blood. However, hemodialysis can also cause electrolyte shifts and complications such as hypotension, muscle cramps, and arrhythmias. Therefore, it is important to monitor the client’s electrolyte levels before and after the treatment to assess the effectiveness and safety of hemodialysis.
Choice A is wrong because monitoring the client’s blood pressure every 4 hours is not frequent enough during hemodialysis.
Hemodialysis can cause rapid changes in blood pressure due to fluid removal and vascular access.
Therefore, blood pressure should be monitored more often, such as every 15 to 30 minutes during hemodialysis.
Choice B is wrong because administering a loop diuretic before the treatment is not indicated for AKI patients receiving hemodialysis.
Loop diuretics are used to increase urine output and reduce fluid overload in AKI patients who have some residual kidney function.
However, hemodialysis can achieve the same goal by removing excess fluid from the blood.
Moreover, loop diuretics can cause electrolyte depletion and ototoxicity, which can worsen the condition of AKI patients.
Choice C is wrong because assessing the client’s respiratory status every 2 hours is not specific enough for hemodialysis treatment.
Hemodialysis can affect respiratory mechanics by altering fluid balance, acid- base status, and oxygen delivery.
Therefore, respiratory status should be assessed more frequently and comprehensively during hemodialysis, such as by measuring respiratory rate, oxygen saturation, arterial blood gas, and chest auscultation.
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