A nurse is teaching a client who has chronic kidney disease about limiting foods that are high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply)
Raisins
Asparagus
Bananas
Tomatoes
Green Beans
Correct Answer : A,C,D
Choice A reason:
Raisins are dried grapes and are known to have a higher concentration of nutrients, including potassium. For individuals with chronic kidney disease (CKD), consuming foods like raisins that are high in potassium can lead to hyperkalemia, a condition where potassium levels in the blood are higher than normal. This can be dangerous as it may cause heart rhythm problems.
Choice B reason:
Asparagus is considered a lower-potassium food, making it a safer choice for people with CKD. It's important for individuals with CKD to manage their potassium intake, but asparagus can be included in their diet in appropriate portions.
Choice C reason:
Bananas are well-known for being rich in potassium. For someone with CKD, eating bananas can contribute to an excessive intake of potassium, which their kidneys may not be able to eliminate efficiently, potentially leading to hyperkalemia.
Choice D reason:
Tomatoes, including tomato products like sauces, juices, and purees, are high in potassium. Therefore, they should be limited or avoided in the diet of a person with CKD to prevent complications associated with high potassium levels.
Choice E reason:
Green beans are considered to be a lower-potassium vegetable. They can be included in a kidney-friendly diet, provided they are consumed in moderation and balanced with other dietary needs.
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Correct Answer is C
Explanation
Choice A reason:
A tingling sensation is not the primary concern when planning preoperative teaching for an amputation due to a severe gangrenous infection. While some patients may experience tingling due to nerve damage or as part of phantom limb sensation, the focus of preoperative teaching should be on managing pain and understanding the recovery process.
Choice B reason:
Telling a patient that their pain will gradually become less severe may be misleading. Post-amputation, patients often experience significant pain, including phantom limb pain, which can be intense and challenging to manage. Preoperative teaching should set realistic expectations about postoperative pain and its management.
Choice C reason:
Phantom pain is a real phenomenon experienced by many amputees, where they feel pain in the amputated limb as if it were still there. It is not merely psychological but has physiological underpinnings related to the nerves and brain's interpretation of signals. Preoperative teaching should include information about phantom limb pain, its potential occurrence, and strategies for managing it.
Choice D reason:
It is unrealistic to suggest that the pain will disappear soon after the amputation. Recovery from an amputation can be a lengthy process, and pain management is a critical component. Patients need to be prepared for the possibility of ongoing pain and the need for pain management strategies postoperatively.
Correct Answer is D
Explanation
Choice A reason:
While the white blood cell (WBC) count is important in assessing the immune system's ability to fight infection, a WBC of 5,000/mm³ is within the normal range (4,500 to 11,000 WBCs/mm³). Therefore, it is not the most critical value for a nurse to prioritize in the care of an HIV patient.
Choice B reason:
A platelet count of 150,000/mm³ is also within the normal range (150,000 to 450,000 platelets/mm³). Although thrombocytopenia can occur in HIV, this value does not indicate an immediate concern for the nurse to prioritize.
Choice C reason:
A positive Western blot test confirms the presence of HIV antibodies, which is indicative of HIV infection. However, this is a diagnostic result rather than a laboratory value that reflects the current status of the patient's immune function or disease progression.
Choice D reason:
The CD4-T-cell count is a critical laboratory value for assessing the immune function of a patient with HIV. A count of 180 cells/mm³ is below the normal range of 500 to 1,200 cells/mm³ and indicates a significantly weakened immune system, placing the patient at risk for opportunistic infections. This value is a priority as it guides treatment decisions and the need for prophylaxis against opportunistic infections.