A patient with a history of polycystic kidney disease is admitted to the surgical unit after having shoulder surgery. Which of the routine postoperative orders is most important for the nurse to discuss with the health care provider?

A. More protein is allowed because urea and creatinine are removed by dialysis: Hemodialysis removes nitrogenous waste products, allowing patients to tolerate a higher protein intake than before dialysis. Adequate protein supports tissue repair and prevents malnutrition, which is common in CKD patients.

B. Dietary potassium is not restricted because the level is normalized by dialysis: Potassium intake still needs monitoring, as hyperkalemia can occur between dialysis sessions. Dialysis does not completely prevent dangerous fluctuations in serum potassium.

C. Unlimited fluids are allowed because retained fluid is removed during dialysis: Fluid intake must still be controlled because excessive consumption can lead to weight gain, hypertension, and edema between dialysis sessions.

D. Increased calories are needed because glucose is lost during hemodialysis: Hemodialysis may result in minimal glucose loss, but the primary dietary focus is on adequate protein intake. Caloric intake should meet overall nutritional needs but is not primarily adjusted.

A. Raisins: Raisins are dried fruits that contain high amounts of potassium. In clients with chronic kidney disease, the kidneys are less able to excrete potassium, increasing the risk of hyperkalemia. Limiting intake of raisins helps maintain safer serum potassium levels.

B. Tomatoes: Tomatoes are naturally high in potassium, and consuming them in large amounts can contribute to elevated potassium levels in clients with kidney impairment. Avoiding or limiting tomato-based foods is important for dietary potassium management.

C. Green Beans: Green beans are relatively low in potassium compared with other vegetables and are generally safe for clients with chronic kidney disease when consumed in moderation. They do not pose a significant risk for hyperkalemia.

D. Asparagus: Asparagus contains moderate amounts of potassium but is lower than high-potassium foods such as bananas or tomatoes. It can usually be included in a kidney-friendly diet in controlled portions.

E. Bananas: Bananas are very high in potassium and are considered a high-risk food for clients with chronic kidney disease. Restricting bananas is essential to prevent dangerous increases in serum potassium levels.