The nurse is instructing the client with chronic kidney disease (CKD) to maintain adequate nutritional intake. Which diet would be most appropriate?

Choice A reason: Administering a muscle relaxant addresses the symptom of muscle twitching and jerking, but it does not identify or treat the underlying cause. For patients with acute pancreatitis, muscle twitching and jerking could be indicative of a more serious condition.

Choice B reason: While a nutritional imbalance could potentially lead to symptoms like muscle twitching and jerking, in the context of acute pancreatitis, the nurse should consider more specific causes related to the condition. Nutritional imbalances do not usually explain these symptoms in patients with pancreatitis as well as hypocalcemia does.

Choice C reason: A reaction to morphine could include various symptoms such as itching, nausea, or constipation, but muscle twitching and jerking are not common side effects. The nurse should consider other causes related to the patient's condition of acute pancreatitis.

Choice D reason: Hypocalcemia, or low calcium levels, is a common complication of acute pancreatitis. It can lead to symptoms such as muscle twitching and jerking, as calcium is crucial for proper muscle function and nerve signaling. This makes hypocalcemia the most relevant and accurate interpretation of the patient's symptoms in this context.

Choice A reason: Obtaining daily weights of the client is the best action to assess the therapeutic effect of furosemide in managing early chronic kidney disease. Daily weights provide valuable information about fluid balance and the effectiveness of the diuretic in reducing fluid retention. Consistent weight monitoring helps determine if the medication is achieving its goal of managing fluid overload, which is a common issue in CKD patients.

Choice B reason: Assessing acid-base balance is important in managing CKD, but it is not the primary action to assess the therapeutic effect of furosemide. While diuretics can influence electrolyte levels and acid-base balance, monitoring fluid status through daily weights is more directly related to evaluating the effectiveness of the medication.

Choice C reason: Assessing the client's serum creatinine is crucial for monitoring kidney function and progression of CKD. However, it is not the primary action to determine the therapeutic effect of furosemide. The focus of furosemide therapy is to manage fluid balance, and daily weights provide a more immediate and relevant assessment of this effect.

Choice D reason: Auscultating heart sounds is part of a comprehensive assessment of a CKD patient, but it is not the best action to evaluate the therapeutic effect of furosemide. Heart sounds can provide information about cardiac function and potential complications, but they do not directly measure the effectiveness of fluid management achieved by the diuretic.