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 D
Explanation
Choice A reason:
Notifying the client that they will receive a food tray in the recovery room is not typically a priority in preoperative education. Nutritional status post-surgery is important, but immediate postoperative care focuses on recovery from anesthesia and monitoring for complications.
Choice B reason:
Reminding the client that they will return to their room after surgery is part of routine information that may help orient the patient postoperatively. However, it is not a specific intervention that will aid in the recovery process or prevent complications.
Choice C reason:
Informing the client that the recovery nurse will instruct them on how to manage postoperative pain is important, but it is not the primary focus of preoperative education. Pain management is typically addressed both preoperatively and postoperatively.
Choice D reason:
Providing instructions on how to cough and deep breathe effectively is a critical component of preoperative education for clients undergoing abdominal surgery. Effective coughing and deep breathing exercises help prevent postoperative complications such as pneumonia and atelectasis by promoting lung expansion and secretion clearance.
Correct Answer is B
Explanation
Choice A Reason:
While performing range of motion exercises is important for maintaining joint function and preventing stiffness, it is not the first action a nurse should take. Range of motion exercises should only be performed after ensuring that there is no compromise in circulation or nerve function.
Choice B Reason:
Checking capillary refill is the correct first action. This quick test assesses the blood flow to the extremity and can indicate if there is any vascular obstruction. A delayed capillary refill time, which is more than 2 seconds, could signify compromised circulation and necessitate immediate intervention.
Choice C Reason:
Discussing cast care is important for client education and preventing complications such as skin breakdown and infection. However, it is not the first priority. The nurse should first ensure the client's physiological stability before providing education.
Choice D Reason:
Managing pain is a critical component of nursing care, especially for clients with fractures. However, the assessment of circulation takes precedence over pain management. Once it is established that there is no immediate threat to the limb's viability, pain management should be addressed promptly.
In summary, the priority for a nurse assessing a client with a cast for a fractured tibia is to check the capillary refill to ensure adequate circulation. This is followed by managing pain, performing range of motion exercises, and discussing cast care with the client.