A client with chronic peripheral arterial disease (PAD) asks the nurse why this disease developed. Which explanation by the nurse is most accurate?

Choice A reason:
Packaged meats, including salami and bacon, are typically high in sodium, which can contribute to increased blood pressure. The American Heart Association recommends that individuals with hypertension limit their sodium intake to no more than 2,300 milligrams per day, with an ideal limit of no more than 1,500 milligrams for most adults². Since packaged meats are often cured with salt, they can significantly contribute to the daily sodium intake, potentially exacerbating hypertension.

Choice B reason:
Grapefruit juice can interact with certain antihypertensive medications, potentially leading to higher levels of the medication in the bloodstream and an increased risk of side effects¹. This interaction occurs because grapefruit juice can inhibit the action of an enzyme that metabolizes medication, leading to an unintended increase in medication levels.

Choice C reason:
Canned soups are often high in sodium, which can contribute to increased blood pressure. Even low-sodium varieties can still contain significant amounts of sodium. It's important for individuals with hypertension to read labels carefully and choose options with the lowest sodium content possible².

Choice D reason:
Fresh fruits are generally recommended for individuals with hypertension. They are rich in potassium, which can help lower blood pressure by balancing out the negative effects of sodium and easing tension in the blood vessel walls¹. Fresh fruits should not be avoided unless there is a specific reason related to another health condition or medication interaction.

Choice E reason:
Fresh shellfish, like fresh fruits, are typically safe for individuals with hypertension to consume. They provide essential nutrients without the added sodium that is found in processed foods. However, it's important to consume them in moderation and to prepare them without adding excessive salt or high-sodium sauces.

Choice A reason:
A respiratory rate of 24/min is slightly elevated, which can be expected in a client with pneumonia due to the body's attempt to increase oxygen intake and carbon dioxide elimination. However, this rate does not directly indicate ineffective airway clearance.

Choice B reason:
A weak, nonproductive cough is a key indicator of ineffective airway clearance. In pneumonia, the presence of secretions in the airways is common, and an effective cough is necessary to clear these secretions. A weak cough that does not produce sputum suggests that the client is unable to clear their airways effectively, which can lead to impaired gas exchange and worsening of symptoms.

Choice C reason:
Pulse oximetry (SpO2) of 90% indicates that the client's oxygen saturation is below the normal range, which is typically between 95-100% for healthy individuals. While this finding is concerning and warrants intervention, it is a result of ineffective airway clearance rather than a direct indicator of it.

Choice D reason:
Shortness of breath with activity is common in clients with pneumonia and can result from various factors, including impaired gas exchange, decreased lung compliance, and increased work of breathing. While it may be associated with ineffective airway clearance, it is not as specific as a weak, nonproductive cough for indicating this particular problem.