A nurse is assisting with the care of a client who has hypertension and chronic kidney disease. The client is scheduled for hemodialysis. Which of the following actions should the nurse plan to take while caring for this client? (Select all that apply.)

The correct answer is Choice A, Choice E

Choice A rationale: Orange juice contains approximately 496 mg of potassium per 8 oz serving, making it a high-potassium beverage. In chronic kidney disease, impaired renal excretion of potassium leads to accumulation and risk of hyperkalemia. Normal serum potassium levels range from 3.5 to 5.0 mEq/L. Elevated levels can cause cardiac arrhythmias, muscle weakness, and paralysis. Avoiding potassium-rich fluids like orange juice is essential to prevent life-threatening complications in clients with reduced glomerular filtration rates.

Choice B rationale: White rice contains approximately 26 mg of potassium per 1 cup cooked, classifying it as a low-potassium food. It is safe for clients with chronic kidney disease and often recommended due to its minimal contribution to serum potassium levels. Unlike whole grains, white rice has reduced mineral content, including potassium and phosphorus. Maintaining serum potassium within the normal range of 3.5 to 5.0 mEq/L is critical, and white rice does not pose a risk of hyperkalemia.

Choice C rationale: Corn flakes cereal contains approximately 30 to 40 mg of potassium per 1 cup serving, making it a low-potassium option suitable for renal diets. It lacks the bran and whole grain components that elevate potassium content in other cereals. In chronic kidney disease, dietary potassium restriction is necessary to prevent hyperkalemia. Corn flakes do not significantly affect serum potassium levels, which should remain between 3.5 and 5.0 mEq/L to avoid neuromuscular and cardiac disturbances.

Choice D rationale: Watermelon contains approximately 112 mg of potassium per 100 grams, which is considered low to moderate. While excessive intake could contribute to potassium load, typical servings do not pose a significant risk. In chronic kidney disease, potassium restriction targets foods exceeding 200 mg per serving. Watermelon’s potassium content is below this threshold, making it generally safe when consumed in moderation. Serum potassium should be maintained within 3.5 to 5.0 mEq/L to prevent hyperkalemia.

Choice E rationale: Bananas contain approximately 422 mg of potassium per medium fruit, placing them among the highest potassium-containing fruits. In chronic kidney disease, potassium excretion is impaired, and consuming bananas can rapidly elevate serum potassium levels. Hyperkalemia increases the risk of ventricular arrhythmias and cardiac arrest. Dietary potassium restriction is essential to maintain levels within the safe range of 3.5 to 5.0 mEq/L. Therefore, bananas should be avoided to prevent life-threatening electrolyte disturbances.

Choice A rationale
Rifampin can cause discoloration of body fluids, including tears, which can stain contact lenses. Therefore, it is recommended to wear glasses instead of contacts while taking this medication.
Choice B rationale
A yellow tint to the skin is not an expected reaction to rifampin. This could indicate jaundice, a sign of liver dysfunction, which requires immediate medical attention.
Choice C rationale

Lifelong treatment with rifampin is not necessary. The typical duration of treatment for active tuberculosis is 6 to 9 months.
Choice D rationale
Rifampin does not cause amenorrhea when taken with oral contraceptives. However, it can reduce the effectiveness of oral contraceptives, so additional contraceptive methods should be used.