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 A
Explanation
Choice A reason:
The inability to move toes can be an early sign that a cast is too tight. This symptom may indicate that the cast is impinging on nerves or blood vessels, leading to decreased motor function. It is essential to address this immediately to prevent further complications such as permanent damage or compartment syndrome.
Choice B reason:
Edema, or swelling of the toes, can occur if a cast is too tight, but it may not be the first sign observed. Swelling is a response to increased pressure in the tissues and can develop over time as fluid accumulates. While it is a concern, it often follows other symptoms such as changes in sensation or movement.
Choice C reason:
Pallor of the toes, indicating reduced blood flow, can be a sign of a cast that is too tight. However, pallor may not be as immediately noticeable as the inability to move toes or changes in sensation. It is still a critical sign that requires prompt evaluation and possible adjustment of the cast.
Choice D reason:
A change in the temperature of the toes, such as them becoming cooler to the touch, can suggest impaired blood flow due to a tight cast. This sign, along with pallor, may develop after other symptoms such as numbness or motor impairment.
Correct Answer is A
Explanation
Choice A reason:
A reddened area over the sacrum is a sign of potential pressure ulcer development, which is a common complication of immobility, especially in bedridden or wheelchair-bound individuals. The sacrum is a prominent bony area that bears weight when a person is sitting or lying down, making it susceptible to pressure ulcers if proper preventative measures, such as regular repositioning, are not taken.
Choice B reason:
Difficulty hearing some types of sounds is not typically a direct complication of immobility. Hearing issues may be related to other health conditions or age-related changes but are not caused by the lack of movement associated with post-stroke immobility.
Choice C reason:
Stiffness in the lower extremities can occur due to immobility, as muscles and joints may become tight when not used regularly. However, this is more of a long-term effect and may not be as immediately concerning as pressure ulcer prevention. Regular range-of-motion exercises can help prevent stiffness.
Choice D reason:
Difficulty moving the upper extremities may be a result of the stroke itself rather than a complication of immobility. While maintaining mobility in all limbs is important, the focus of monitoring should be on complications that arise specifically due to immobility, such as pressure ulcers.