A client has recently undergone a kidney transplant.
Which of the following diet and activity recommendations should the nurse provide?

Choice A rationale

Hypertension is a major modifiable risk factor for the progression of polycystic kidney disease (PKD) to end-stage renal disease (ESRD). Uncontrolled blood pressure exacerbates glomerular damage and accelerates the decline in renal function. Effective blood pressure control, often targeting specific parameters, significantly reduces the strain on kidneys, preserving nephron function and delaying ESRD.

Choice B rationale

While blood glucose control is crucial for clients with diabetes to prevent diabetic nephropathy, it is not the primary or most important intervention for slowing the progression of polycystic kidney disease (PKD). PKD is an inherited disorder characterized by cyst formation, and its progression is mainly driven by factors like hypertension.

Choice C rationale

Fluid restriction is generally not a primary intervention for slowing the progression of polycystic kidney disease (PKD). In fact, maintaining adequate hydration is often encouraged to prevent dehydration and reduce the risk of kidney stone formation, which can be a complication in PKD. Fluid management is individualized based on kidney function.

Choice D rationale

Pain management is important for comfort in clients with polycystic kidney disease (PKD) dueating to cyst enlargement or complications. However, managing pain does not directly slow the progression of the underlying disease process to end-stage renal disease (ESRD). The primary focus for slowing progression is on managing factors that directly impact renal function.

Choice A rationale

Fluid-filled vesicles on the chest are not characteristic of Koplik spots. Vesicular rashes are more commonly associated with conditions like varicella (chickenpox) or herpes zoster, where the viral replication leads to the formation of small, elevated, fluid-filled lesions on the skin surface.

Choice B rationale

Koplik spots are pathognomonic for measles, appearing as small, irregular, bright red spots with bluish-white centers on the buccal mucosa, typically opposite the molars. They represent necrotic epithelial cells in the buccal mucosa and are an early diagnostic sign, often appearing 2-3 days before the generalized rash.

Choice C rationale

Enlarged parotid glands are characteristic of mumps, a viral infection affecting the salivary glands, particularly the parotid glands. This condition leads to swelling and tenderness in the areas anterior to the ears and below the jawline, distinct from the oral lesions seen in measles.

Choice D rationale

A gray pseudomembrane covering the pharynx is a hallmark sign of diphtheria, a bacterial infection caused by *Corynebacterium diphtheriae*. This pseudomembrane is a tough, adherent lesion composed of fibrin, bacteria, and necrotic cells that can obstruct the airway, unrelated to measles.