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

Low-protein, high-potassium.

High-calcium, high-potassium, high-protein.

High-carbohydrate, high-protein.

Low-protein, low-sodium, low-potassium.

Answer and Explanation

The Correct Answer is D

Choice A reason: A low-protein diet can be beneficial in reducing the workload on the kidneys by decreasing the production of waste products that need to be excreted. However, high-potassium intake is not recommended for CKD patients because their kidneys may not efficiently excrete potassium, leading to hyperkalemia, which can be dangerous.

Choice B reason: A diet high in calcium, potassium, and protein is not suitable for CKD patients. Excessive protein can increase the production of waste products, calcium intake needs to be monitored to avoid complications like calcification, and high potassium levels can lead to hyperkalemia. This combination could potentially worsen the patient's condition.

Choice C reason: A high-carbohydrate, high-protein diet is not ideal for CKD patients. While carbohydrates can provide energy, high protein intake increases the load on the kidneys. The goal is to reduce the production of waste products that the kidneys need to filter, so a high-protein diet is counterproductive.

Choice D reason: A low-protein, low-sodium, low-potassium diet is most appropriate for CKD patients. Reducing protein intake decreases the production of waste products, low sodium helps control blood pressure and fluid balance, and low potassium prevents hyperkalemia. This diet helps manage the symptoms and progression of CKD more effectively.

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Correct Answer is C

Explanation

Choice A reason: Immediate return to hemodialysis is not typically the first line of treatment for these symptoms. Hemodialysis is a renal replacement therapy used when the kidneys are not functioning adequately. While it may be necessary in some cases, the symptoms described suggest an infection rather than complete kidney failure.

Choice B reason: Immediate removal of the transplanted kidney is a drastic measure and is not the first step in managing these symptoms. This action would be considered only if there is clear evidence of irreversible graft failure or severe complications that cannot be managed with other treatments.

Choice C reason: Antibiotic therapy is

The correct answer. The symptoms of oliguria (low urine output), elevated temperature, increased blood pressure, and signs of fluid retention suggest an infection, which is a common complication after kidney transplantation due to the immunosuppressive medications that lower the immune system's ability to fight infections. Treating the infection with antibiotics is crucial to prevent further complications and preserve the function of the transplanted kidney.

Choice D reason: Increased doses of immunosuppressive drugs are not appropriate in this situation. While immunosuppressive drugs are essential to prevent organ rejection, increasing their dosage in the presence of an infection could further compromise the immune system and exacerbate the infection. The priority is to address the infection first.

A. Warfarin B. Atropine C. Dobutamine D. Magnesium sulfate

Correct Answer is A

Explanation

Choice A reason: Warfarin is an anticoagulant commonly used in patients with atrial fibrillation to prevent the formation of blood clots. Atrial fibrillation increases the risk of stroke due to the potential for blood clots forming in the heart and traveling to the brain. Warfarin helps reduce this risk by thinning the blood and preventing clot formation.

Choice B reason: Atropine is used to treat bradycardia (slow heart rate) and is not typically used for patients with atrial fibrillation. Its primary function is to increase the heart rate by blocking the vagus nerve's effects on the heart. In the context of atrial fibrillation, anticoagulation is more crucial to prevent complications like stroke.

Choice C reason: Dobutamine is an inotropic agent used to increase cardiac output in patients with heart failure or cardiogenic shock. It is not used for managing atrial fibrillation. Dobutamine works by stimulating the heart to pump more effectively but does not address the risks associated with atrial fibrillation, such as blood clot formation.

Choice D reason: Magnesium sulfate is used to treat various conditions, including torsades de pointes (a type of abnormal heart rhythm) and severe asthma attacks. It is not typically used for atrial fibrillation. The focus in atrial fibrillation management is on controlling the heart rate or rhythm and preventing thromboembolic complications with anticoagulation therapy.

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

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