A nurse is performing discharge teaching with a client who was admited for pyelonephritis. Which of the following instructions related to the prevention of pyelonephritis should the nurse include in the teaching? (Select all that apply.)

Choice A reason: A BUN level of 8 mg/dL and a creatinine level of 0.7 mg/dL are within normal ranges for healthy individuals. In CKD, BUN and creatinine levels are typically elevated due to decreased kidney function.

Choice B reason: A BUN level of 45 mg/dL is elevated, which could be expected in CKD, but a creatinine level of 8 ng/dL is not correctly expressed. Creatinine is measured in mg/dL, and in CKD, it would be higher than normal, not lower.

Choice C reason: A BUN level of 10 mg/dL and a creatinine level of 0.3 mg/dL are both lower than what would typically be expected in a patient with CKD. CKD usually results in higher levels due to reduced kidney function.

Choice D reason: A BUN level of 23 mg/dL and a creatinine level of 1.0 mg/dL are more aligned with what might be expected in CKD. Normal BUN levels range from 7 to 20 mg/dL, and normal creatinine levels can vary based on age, sex, and body size. In CKD, both levels tend to be higher as the kidneys' ability to filter blood decreases.

Choice A reason: Taking 3,000 mg of vitamin C daily is not recommended as it may increase the risk of calcium oxalate stones due to possible conversion of vitamin C to oxalate.

Choice B reason: Drinking 3 L of fluid every day is advised to prevent kidney stones by diluting the urine and reducing the concentration of stone-forming substances.

Choice C reason: Eating 12 oz of animal protein daily is excessive and can increase the risk of kidney stones due to higher excretion of calcium and oxalate.

Choice D reason: Restricting calcium intake to one serving per day is not recommended as a normal calcium intake is necessary to bind oxalate in the gut and reduce oxalate absorption.