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 B
Explanation
Choice A reason:
Decreased hemoglobin (Hgb) levels can be indicative of anemia or blood loss, but they are not typically associated with fluid volume deficit. In cases of fluid volume deficit, the Hgb concentration may actually appear elevated due to hemoconcentration as the plasma volume decreases.
Choice B reason:
Increased blood urea nitrogen (BUN) levels are expected in a fluid volume deficit because as the blood volume decreases, the concentration of solutes like urea can increase. This is often due to decreased renal perfusion and subsequent reduced renal function, leading to less urea being excreted through the kidneys.
Choice C reason:
Increased urine ketones are typically associated with diabetic ketoacidosis or starvation, not directly with fluid volume deficit. Ketones are produced when the body breaks down fats for energy, which is not a process directly related to fluid volume status.
Choice D reason:
Decreased urine specific gravity would not be expected in fluid volume deficit; in fact, one would expect the opposite. Specific gravity measures the kidney's ability to concentrate urine. In fluid volume deficit, the urine specific gravity would likely be increased as the body attempts to conserve water.
Correct Answer is D
Explanation
Choice A reason:
Annular lesions are ring-shaped with a clear center, which does not describe a lesion with a wavy border. This term is typically used for lesions like ringworm, which present as circular rashes with normal skin in the center.
Choice B reason:
Circinate lesions are also circular but are not characterized by a wavy border. They are similar to annular lesions but often have a more rounded edge and are associated with conditions like psoriasis.
Choice C reason:
Coalesced lesions refer to multiple lesions that have merged to form a larger one. While they can have irregular borders, 'coalesced' does not specifically describe the wavy nature of the border.
Choice D reason:
Serpiginous lesions have a wavy or snake-like border, which matches the description provided by the nurse. This term is often used for parasitic infections, such as cutaneous larva migrains, which create a trail-like pattern on the skin.