A nurse is teaching a client with hypertension about dietary modifications. Which recommendation is most appropriate to reduce blood pressure?

Choice A reason: Caregiver role strain addresses the burden on parents or guardians. While important, it is not the highest priority compared to the client’s direct health needs. Developmental issues in a child take precedence, as they can have long-term impacts on physical, cognitive, and social growth, requiring immediate intervention.

Choice B reason: Risk for delayed development is critical in pediatric clients, as it affects cognitive, physical, and emotional growth. Early identification and intervention can mitigate long-term consequences, such as learning disabilities or social deficits. This diagnosis takes priority, as it directly impacts the child’s health and future functioning, requiring urgent attention.

Choice C reason: Sleep deprivation can affect health and development but is less urgent than developmental delays, which have broader, long-term consequences. Sleep issues may contribute to developmental problems but are typically secondary. Addressing underlying causes, like developmental risks, often resolves related symptoms like poor sleep more effectively.

Choice D reason: Altered urinary elimination, such as incontinence, may indicate a medical issue but is generally less critical than developmental delays in a pediatric client. It may be a symptom of developmental issues but does not take precedence over addressing potential delays that impact overall growth and function.

Choice A reason: Urinary retention, the inability to empty the bladder, is unlikely with diuretics, which increase urine output. Diuretics reduce fluid volume by enhancing renal excretion, not causing retention. This concern is irrelevant, as the client’s increased output suggests effective diuresis, not bladder dysfunction or obstruction.

Choice B reason: Decreased fluid volume risk is a primary concern with diuretics, which increase urine output, potentially causing dehydration or electrolyte imbalances (e.g., hypokalemia). Education on fluid intake, monitoring weight, and recognizing dehydration symptoms is critical to prevent hypovolemia, ensuring safe diuretic use and maintaining physiological stability.

Choice C reason: Altered skin integrity may occur secondary to dehydration (dry skin) but is not the primary concern with diuretics. The main risk is fluid volume loss, which can lead to systemic complications like hypotension. Education should focus on fluid balance rather than skin, which is a secondary issue.

Choice D reason: Altered urinary elimination, such as incontinence, is not the primary concern, as diuretics increase output, not disrupt elimination patterns. While frequent urination may occur, the critical issue is fluid volume loss, which poses greater risks like dehydration or electrolyte imbalances, necessitating education on fluid management.