The nurse is caring for a 32-year-old female patient coming to the clinic with peripheral edema, periorbital edema, and flank pain. Use the chart to answer the questions.

Exhibits

Which items should the nurse include when teaching the patient and family about dialysis? Select all that apply.

A.    Polycythemia (an abnormally high red blood cell count) is not typically a primary concern in dialysis patients; instead, they are more often monitored for anemia.
B.    Dialysis patients often need to restrict fluid intake to prevent fluid overload, which can exacerbate edema and cause additional cardiovascular strain.
C.    Daily weight monitoring is crucial for dialysis patients to track fluid balance and detect any sudden changes that might indicate fluid retention or loss.
D.    Frequent oral care is important to prevent infections, particularly because dialysis patients are at increased risk due to their compromised immune systems and possible fluid restrictions, which can lead to dry mouth and other oral health issues.
E.    Dialysis patients may need a modified protein intake, depending on their specific needs and the type of dialysis (hemodialysis vs. peritoneal dialysis). Protein needs can vary, so it is essential to follow the specific dietary recommendations provided by a healthcare provider.
F.    Avoiding nephrotoxic substances (e.g., certain medications, contrast dyes) is critical to protect the remaining kidney function and prevent further damage.
G.    A low-sodium diet helps manage blood pressure and fluid balance, reducing the risk of fluid retention and hypertension in dialysis patients.
 
H.    Monitoring urine output is important to assess kidney function and fluid balance.

Even though dialysis takes over some kidney functions, any remaining urine output can provide valuable information about the patient's residual kidney function.