A nurse is providing dietary teaching to a client who has a history of recurring calcium oxalate kidney stones. Which of the following instructions should the nurse include in the teaching?
 

Choice A reason: Asparagus is not typically high in potassium and does not need to be avoided by clients with chronic

kidney disease.

Choice B reason: Raisins are high in potassium and should be avoided by clients with chronic kidney disease to prevent hyperkalemia.

Choice C reason: Bananas are known to be high in potassium and should be limited or avoided in clients with chronic kidney disease.

Choice D reason: Tomatoes and tomato products are high in potassium and should be avoided to maintain safe

potassium levels.

Choice E reason: Green beans are not considered high in potassium and do not typically need to be avoided by clients with chronic kidney disease.

Choice A reason: Aluminum hydroxide does not primarily lower serum calcium levels. Calcium levels are typically managed in CKD patients through other medications and dietary restrictions, as hypercalcemia can occur in these patients.

Choice B reason: Aluminum hydroxide acts as a phosphate binder, which helps to lower serum phosphorus levels in patients with CKD. This is important because high phosphorus levels can lead to bone and heart problems in these patients. The normal range for serum phosphorus is approximately 2.5 to 4.5 mg/dL.

Choice C reason: Aluminum hydroxide does not have a significant effect on serum potassium levels. In CKD, potassium levels are managed through diet and other medications due to the risk of hyperkalemia, which can be life- threatening.

Choice D reason: While magaldrate contains magnesium, which could potentially worsen hypermagnesemia in CKD patients, aluminum hydroxide does not lower serum magnesium levels. Instead, it is less likely to cause elevated magnesium levels compared to magaldrate.