A client with Crohn's disease has a serum sodium level of 130 mEq/L (130 mmol/L). Which foods should the practical nurse (PN) encourage the client to eat?

Reference Range:

• Sodium: 136 to 145 mEq/L (136 to 145 mmol/L)

Choice A reason: Coughing over the catheter site while cleansing the skin is a behavior that indicates the client needs additional teaching. This action can introduce bacteria and other pathogens to the catheter site, increasing the risk of infection. Proper technique should include covering the mouth when coughing and ensuring the area remains as sterile as possible during the cleansing process. Educating the client on the importance of maintaining sterility and preventing contamination is crucial in peritoneal dialysis catheter care.
Choice B reason: Wearing only one sterile glove when cleansing the insertion site may not be ideal, but it does not necessarily indicate a lack of understanding or need for additional teaching. The main concern is ensuring the insertion site is cleaned properly. However, best practice would be to wear two sterile gloves to maintain sterility and reduce the risk of infection.
Choice C reason: Washing hands before opening the 4 by 4 dressing packet is a proper and essential technique in peritoneal dialysis catheter care. This action helps minimize the risk of infection by ensuring that the hands are clean before handling sterile supplies. This behavior does not indicate a need for additional teaching.
Choice D reason: Pouring antiseptic solution and sterile water on sterile dressings is an acceptable practice in peritoneal dialysis catheter care. This step helps disinfect the catheter site and maintain sterility. This behavior does not indicate a need for additional teaching.

Choice A reason: Palpating the client's neck gently is important in assessing thyroid function, as it can help detect the presence of thyroid enlargement or nodules. However, this action does not confirm the presence of exophthalmos, which is characterized by the protrusion of the eyeballs. Neck palpation is useful for evaluating thyroid size and consistency but does not provide information about eye-related symptoms.
Choice B reason: Measuring the client's vital signs, including heart rate, blood pressure, and temperature, is essential in monitoring the overall health and metabolic status of a client with hyperthyroidism. Hyperthyroidism can lead to increased heart rate, elevated blood pressure, and other systemic effects. However, measuring vital signs does not confirm the presence of exophthalmos. While vital signs provide important information about the client's condition, they do not address specific eye symptoms.
Choice C reason: Compressing the client's pretibial area is typically performed to assess for pretibial myxedema, which is another possible manifestation of hyperthyroidism, particularly in Graves' disease. Pretibial myxedema is characterized by thickening and swelling of the skin on the lower legs. However, this action does not confirm the presence of exophthalmos. It is important to assess for both pretibial myxedema and exophthalmos in clients with hyperthyroidism, but they require different examination techniques.
Choice D reason: Observing the client's face and eyes is the correct action to confirm the presence of exophthalmos. Exophthalmos is the abnormal protrusion of the eyeballs and is a common feature of Graves' disease, a type of hyperthyroidism. By carefully examining the client's face and eyes, the practical nurse can look for signs of eye protrusion, lid retraction, and other related symptoms. This focused assessment helps in identifying exophthalmos and determining the extent of the condition, which is essential for appropriate management and treatment.