A client with CKD who is on hemodialysis asks for a snack in the afternoon. The patient's potassium level is elevated. Which of the following foods could be given? Select all that apply.

Choice a reason: Starting the flow of urine before passing the container under the stream to collect the specimen is an appropriate instruction. This technique is recommended to ensure that the initial part of the urine, which may contain contaminants from the urethral opening, is not collected. By allowing the first part of the urine to flow into the toilet, the midstream portion is considered cleaner and more representative for diagnostic testing.
Choice b reason: Removing the specimen container before stopping the stream of urine is also an appropriate instruction. This helps to ensure that only the midstream portion of the urine is collected, minimizing the risk of contamination from the skin or other surfaces. It also prevents the urine from splashing or overflowing, which could potentially contaminate the sample or the surrounding area.
Choice c reason: Using the provided towelette to cleanse the area by moving in a back-and-forth motion is incorrect and requires intervention. The proper technique for cleansing the area involves using the towelette to wipe from front to back in a single, continuous motion. This helps to reduce the risk of introducing bacteria from the perineal area into the urinary tract, which can lead to inaccurate test results or urinary tract infections.
Choice d reason: Instructing the client to use their non-dominant hand to spread the labia is an appropriate instruction. This technique helps to ensure that the urinary meatus is exposed and that the urine flows directly into the specimen container. Using the non-dominant hand allows the dominant hand to be used for holding and positioning the specimen container, making the process more manageable and reducing the risk of contamination.

Choice a reason: Assessing kidney function is typically done using less invasive tests, such as blood tests to measure serum creatinine and blood urea nitrogen (BUN), and urine tests to assess protein levels, blood, and other markers. While renal biopsy provides detailed information about kidney tissue, it is not the primary method used solely for assessing kidney function.
Choice b reason: Diagnosing kidney diseases is the primary purpose of a renal biopsy. This procedure involves taking a small sample of kidney tissue, which is then examined under a microscope. A renal biopsy can provide detailed information about the type, severity, and progression of kidney disease, helping healthcare providers to make accurate diagnoses and develop appropriate treatment plans. It is particularly useful in cases of unexplained kidney dysfunction, nephrotic syndrome, and certain types of glomerulonephritis.
Choice c reason: Treating kidney infections is typically done through medication, primarily antibiotics. A renal biopsy is not used as a treatment method for infections. While it may help diagnose conditions that predispose to infections, the biopsy itself does not serve as a treatment for kidney infections.
Choice d reason: Removing kidney stones is performed through various surgical and non-surgical methods, such as lithotripsy, ureteroscopy, or percutaneous nephrolithotomy. A renal biopsy is not used for the removal of kidney stones. Instead, it focuses on obtaining tissue samples for diagnostic purposes, not for treating or removing physical obstructions like stones.