A nurse is reinforcing nutrition teaching for a client who has chronic kidney disease about limiting foods high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply.)

Orange juice.

White rice.

Corn flakes cereal.

Watermelon.

Bananas.

Answer and Explanation

Correct Answer : A,E

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.

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Correct Answer is D

Explanation

Choice A rationale
While feeling depressed is a significant concern, it is not the highest priority in the context of systemic lupus erythematosus (SLE). Depression should be addressed, but it does not pose an immediate threat to the client’s physical health.
Choice B rationale
Joint pain in hands and knees is a common symptom of SLE but is not the highest priority. It indicates inflammation but does not pose an immediate risk to the client’s overall health.
Choice C rationale
A dry, raised rash on the face, often referred to as a “butterfly rash,” is a characteristic symptom of SLE. However, it is not the highest priority to report as it does not pose an immediate threat.
Choice D rationale
Presence of peripheral edema is the highest priority to report because it can indicate kidney involvement, which is a serious complication of SLE. Kidney damage can lead to significant health issues and requires immediate attention.

A. Position the lower extremities so that they are touching. B. Ensure that the client’s heels are touching the bed. C. Instruct the client to avoid movement of the affected leg. D. Prevent hip flexion of the affected extremity.

Correct Answer is D

Explanation

Choice A rationale
Positioning the lower extremities so that they are touching is incorrect because it can lead to adduction of the hip, which increases the risk of dislocation. After a total hip arthroplasty, it is important to maintain proper alignment of the hip joint to prevent dislocation. Keeping the legs apart with the use of an abduction pillow or wedge is recommended to maintain proper alignment and reduce the risk of complications.
Choice B rationale

Ensuring that the client’s heels are touching the bed is incorrect because it can lead to pressure ulcers. After a total hip arthroplasty, it is important to prevent pressure on the heels by using pillows or heel protectors to elevate the heels off the bed. This helps to reduce the risk of pressure ulcers and promotes better circulation to the lower extremities.
Choice C rationale
Instructing the client to avoid movement of the affected leg is incorrect because early mobilization is important for recovery. After a total hip arthroplasty, patients are encouraged to perform gentle exercises and mobilize as soon as possible to prevent complications such as deep vein thrombosis (DVT) and to promote healing. Immobilization can lead to stiffness, muscle atrophy, and other complications.
Choice D rationale
Preventing hip flexion of the affected extremity is correct because excessive hip flexion can increase the risk of dislocation. After a total hip arthroplasty, it is important to avoid positions that involve hip flexion greater than 90 degrees, such as sitting in low chairs or bending forward excessively. Maintaining proper hip precautions helps to reduce the risk of dislocation and promotes a safe recovery.

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A nurse is reinforcing nutrition teaching for a client who has chronic kidney disease about limiting foods high in potassium. Which of the following foods should the nurse instruct the client to avoid? (Select all that apply.)

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