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: Fat embolism syndrome (FES) is a serious complication that can occur after a long bone fracture. It happens when fat droplets from the bone marrow enter the bloodstream and travel to the lungs, brain, or other organs, causing a range of symptoms. These can include respiratory distress, cerebral symptoms like confusion or agitation, and petechial rash. The practical nurse must be vigilant for early signs of fat embolism, such as changes in mental status, tachypnea, and hypoxia, as timely intervention is critical to prevent severe outcomes. Monitoring the client's oxygen saturation, respiratory rate, and level of consciousness is essential in detecting this potentially life-threatening condition.
Choice B reason: Urinary retention can be a concern postoperatively due to anesthesia and immobility. While it is important to monitor urinary output and ensure the client is voiding adequately, urinary retention is not as immediately life-threatening as a fat embolism. The practical nurse should still assess bladder function and encourage measures to promote voiding, such as adequate hydration and mobility. However, this complication does not take precedence over the potential for a fat embolism in the early postoperative period following a long bone fracture repair.
Choice C reason: Nonunion refers to the failure of the fracture to heal properly, which can lead to chronic pain and functional impairment. It is a significant complication that requires attention, but it typically develops over a longer period rather than immediately postoperatively. The practical nurse should monitor for signs of nonunion, such as persistent pain and lack of healing on follow-up X-rays. However, this is not the most urgent concern in the immediate postoperative period when compared to the risk of a fat embolism.
Choice D reason: Muscular spasms can occur after a fracture as the muscles around the injury site contract to protect and stabilize the affected area. While muscle spasms can be painful and affect the client's comfort and mobility, they are generally not life-threatening. The practical nurse should address muscle spasms through pain management strategies and physical therapy, but this complication is not as critical as the potential for a fat embolism in the immediate postoperative period.

Choice A reason: Red meats are typically high in sodium, especially if they are processed or cured. Encouraging the consumption of red meats would not be appropriate for a client with low sodium levels.
Choice B reason: Salted crackers are high in sodium and should be avoided for a client with low sodium levels. Consuming salted crackers would further decrease the sodium level, which is not desirable in this case.
Choice C reason: Fresh fruits are naturally low in sodium and are a good choice for a client with low sodium levels. They provide essential vitamins and nutrients without adding excess sodium to the diet.
Choice D reason: Green vegetables are also low in sodium and are a healthy option for a client with low sodium levels. However, fresh fruits are often more palatable and easier to incorporate into the diet, making them a better choice for encouraging the client to eat.