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:
Clay-colored stools are typically associated with issues in the biliary system, such as bile duct obstruction or liver infections, and not directly with aspirin use. Aspirin does not typically cause a change in stool color unless there is gastrointestinal bleeding, which would more likely result in black, tarry stools.
Choice B reason:
Nystagmus, which is a vision condition characterized by repetitive, uncontrolled eye movements, is not a known side effect of aspirin. This condition is more commonly associated with neurological disorders, certain medications, or alcohol intoxication.
Choice C reason:
Tinnitus, or ringing in the ears, is a recognized adverse effect of aspirin, especially when taken in high doses or for a prolonged period. It occurs due to aspirin's effect on the inner ear's cochlear cells and can be a sign of salicylate toxicity.
Choice D reason:
Respiratory depression is not a typical side effect of aspirin. Aspirin can cause respiratory alkalosis in cases of overdose, but it does not depress respiration. Instead, it may cause hyperventilation due to stimulation of the respiratory center in the brain.
Correct Answer is C
Explanation
Choice A reason:
Monitoring the client for hypoglycemia is important after an insulin overdose, as symptoms can develop if blood glucose levels fall too low. Symptoms of hypoglycemia include sweating, shaking, confusion, irritability, and in severe cases, seizures or loss of consciousness. While monitoring is crucial, it is not the immediate priority action to take.
Choice B reason:
Completing an incident report is an administrative task that should be done after immediate care has been provided to the client. It is important for documenting the error and for the healthcare facility to review processes and prevent future incidents. However, it is not the priority action when a client's health is at immediate risk.
Choice C reason:
The immediate priority is to give the client 15 to 20 g of carbohydrate to prevent hypoglycemia. This is because the insulin dose was higher than needed for the actual blood glucose level, which could cause the client's blood sugar to drop rapidly. Fast-acting carbohydrates will help to quickly raise blood sugar levels and prevent hypoglycemic symptoms.
Choice D reason:
Notifying the nurse manager is important, but it is not the immediate priority. The nurse manager should be informed of the incident after the client's safety is ensured and after taking steps to correct the insulin overdose.