A nurse is providing teaching to a client who is scheduled for a kidney transplantation. Which of the following statements by the client indicates an understanding of the teaching?

Rationale for Correct Choices:

• "I should increase green leafy vegetables in my diet.": Green leafy vegetables such as spinach and kale are plant-based sources of non-heme iron, which can help improve iron stores, especially in clients following a vegan diet. Pairing them with vitamin C-rich foods can further enhance iron absorption.
• "The iron supplement might cause my stools to be black.": Black, tarry stools are a common and harmless side effect of oral iron supplements. It results from unabsorbed iron in the gastrointestinal tract and does not indicate gastrointestinal bleeding.
• "I will take my iron supplement 1 hour before a meal.": Iron is best absorbed on an empty stomach, ideally 1 hour before or 2 hours after meals. Taking it before a meal enhances absorption, although food may be added later if gastric irritation occurs.

Rationale for Incorrect Choices:

• "The iron supplement might cause ringing in my ears.": Tinnitus (ringing in the ears) is not a typical or expected side effect of iron supplementation. Its presence may indicate another issue and should be reported rather than expected as normal during iron therapy.
• "I should expect to have swelling in my feet.": Peripheral edema is not associated with iron supplements. Swelling in the feet could suggest cardiac, renal, or vascular issues and should prompt further assessment rather than being anticipated.

A. Magnetic resonance imaging (MRI) of the abdomen: An MRI is a safe diagnostic procedure for clients with reduced kidney function, as it does not involve the use of nephrotoxic contrast material. This is typically safe for clients with kidney issues.

B. Kidney, ureter, bladder (KUB) radiograph: A KUB radiograph is a simple X-ray of the abdomen and does not involve contrast. It is safe for clients with reduced kidney function and can be used to assess the kidneys and urinary system.

C. Renal ultrasound: A renal ultrasound is a non-invasive imaging procedure that uses sound waves to assess kidney structure and function. It does not require contrast and is safe for clients with reduced kidney function.

D. CT scan with contrast: Contrast material can be nephrotoxic, especially in clients with reduced kidney function. This can lead to contrast-induced nephropathy, which should be avoided or carefully managed in patients with kidney impairment.