The nurse is planning to teach a client with gastroesophageal reflux disease (GERD) about substances to avoid. Which items would the nurse include on this list? (Select all that apply)

Choice A reason: Red meat is not high in potassium, so it’s safe with potassium-sparing diuretics. Citrus fruits, high in potassium, risk hyperkalemia, making this incorrect, as it’s not a food the nurse would teach the client to avoid or use cautiously.

Choice B reason: Bread has low potassium content and is safe with potassium-sparing diuretics. Salt substitutes containing potassium are riskier, making this incorrect, as it’s not a food the nurse would include in teaching for cautious use with the diuretic.

Choice C reason: Citrus fruits, like oranges, are high in potassium, risking hyperkalemia with potassium-sparing diuretics. This aligns with dietary teaching, making it a correct food the nurse would teach the client to avoid or use cautiously to prevent electrolyte imbalance.

Choice D reason: Cereal is generally low in potassium unless fortified, not requiring caution with potassium-sparing diuretics. Citrus fruits are a concern, making this incorrect, as it’s not a primary food the nurse would teach the client to limit in the diet.

Choice E reason: Eggs are low in potassium and safe with potassium-sparing diuretics. Salt substitutes pose a hyperkalemia risk, making this incorrect, as it’s not a food the nurse would include in teaching for cautious use in the client’s dietary plan.

Choice F reason: Salt substitutes often contain potassium chloride, increasing hyperkalemia risk with potassium-sparing diuretics. This aligns with dietary education, making it a correct item the nurse would teach the client to avoid or use cautiously to prevent complications.

Choice A reason: Testing skin turgor assesses dehydration, not severe hyponatremia (118 mEq/L), which affects neurological status. Assessing cognition detects complications, making this incorrect, as it’s less critical than the nurse’s priority of monitoring for hyponatremia’s neurological and fluid effects.

Choice B reason: Assessing cognition is critical with a sodium level of 118 mEq/L, as severe hyponatremia causes confusion or seizures. This aligns with neurological assessment, making it a correct action the nurse should perform to prevent harm in the hyponatremic client.

Choice C reason: Monitoring urine output tracks fluid balance, vital in hyponatremia to assess for SIADH or fluid overload. This aligns with renal assessment, making it a correct action the nurse should perform to prevent harm in the client with severe hyponatremia.

Choice D reason: Checking deep tendon reflexes detects neurological changes from hyponatremia, such as hyporeflexia or seizures. This aligns with neurological monitoring, making it a correct assessment the nurse should perform to prevent harm in the client with a sodium of 118 mEq/L.

Choice E reason: Abdominal pain is unrelated to hyponatremia, which primarily affects the brain and fluid balance. Monitoring urine output is more relevant, making this incorrect, as it’s not a priority assessment for the nurse to prevent harm in the hyponatremic client.

Choice F reason: Fever may indicate infection but isn’t directly linked to hyponatremia’s neurological risks. Assessing cognition is critical, making this incorrect, as it’s less urgent than the nurse’s focus on preventing harm from severe hyponatremia’s neurological complications.