A nurse is providing dietary teaching to a client who has chronic kidney disease (CKD). The nurse should instruct the client to limit which of the following nutrients? (Select all that apply.)
Potassium
Calcium
Iron
Phosphorous
Correct Answer : A,B,D
A) Potassium: CKD can lead to hyperkalemia (high potassium levels) as the kidneys lose their ability to excrete potassium effectively. Limiting potassium intake helps prevent elevated potassium levels and reduces the risk of cardiac arrhythmias.
B) Calcium: In CKD, impaired kidney function can lead to abnormalities in calcium and phosphorus metabolism, which can result in secondary hyperparathyroidism. Limiting calcium intake can help manage the imbalances in calcium and phosphorus levels.
(D) Phosphorus: Impaired kidney function in CKD leads to decreased phosphate excretion, resulting in hyperphosphatemia (high phosphorus levels). High phosphorus levels can lead to bone disease and other complications, so limiting phosphorus intake is essential.
Iron (C) is not typically limited in the diet of a client with CKD unless they have iron overload or specific conditions that warrant iron restriction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Diuretics are the primary class of drugs used to treat volume overload in patients with acute decompensated heart failure (ADHF). These medications help to increase urine output, reducing the overall fluid volume in the body and relieving congestion in the lungs and other tissues.
The goal of using diuretics in ADHF is to alleviate symptoms such as shortness of breath, edema (swelling), and fluid retention by promoting the elimination of excess fluid. The most commonly used diuretics in this setting are loop diuretics (e.g., furosemide, bumetanide), which have a potent diuretic effect and can rapidly reduce fluid overload.
While narcotics, vasodilators, and positive inotropes may have roles in specific cases of ADHF, they are not the primary drugs used to treat volume overload. Narcotics may be used for pain management, vasodilators to reduce afterload (the resistance the heart has to pump against), and positive inotropes to increase the heart's contractility in certain situations. However, the first-line treatment for volume overload in ADHF is diuretic therapy.
Correct Answer is A
Explanation
In a client with chronic kidney disease (CKD), metabolic acidosis is a common acid-base disorder due to impaired excretion of acid and decreased bicarbonate reabsorption in the kidneys. The arterial blood gas values associated with metabolic acidosis in CKD are a low pH (acidemia), low bicarbonate (HCO3-), and normal or low partial pressure of carbon dioxide (PaCO2). Option A fits this pattern, with a pH of 7.25 (acidic), HCO3- of 19 mEq/L (low), and a PaCO2 of 30 mm Hg (within the normal to low range).
Option B shows a pH of 7.30 (acidic) but with a higher bicarbonate level of 26 mEq/L, which is not consistent with metabolic acidosis. The elevated bicarbonate level suggests metabolic alkalosis, which is not expected in a client with CKD.
Option C has a pH of 7.50 (alkaline) with an elevated bicarbonate level of 20 mEq/L and a low PaCO2 of 32 mm Hg. This set of values is indicative of metabolic alkalosis, which is not expected in a client with CKD.
Option D has a pH of 7.55 (alkaline) with an elevated bicarbonate level of 30 mEq/L and a low PaCO2 of 31 mm Hg. This set of values is indicative of metabolic alkalosis, which is not expected in a client with CKD.
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