The nurse is providing care for a patient admitted with severe flank pain identified as renal colic. Urinalysis is positive for microscopic hematuria. Which action should the nurse take?

Choice a reason: Eliminating ingestion of foods high in protein is not entirely accurate. While it is important for clients with chronic kidney disease (CKD) to manage their protein intake, eliminating it completely is not recommended. Instead, they should consume controlled amounts of high-quality protein, as protein is necessary for maintaining muscle mass and overall health. However, excessive protein intake can increase the workload on the kidneys and accelerate the progression of kidney disease.
Choice b reason: Reducing intake of foods high in potassium is essential for clients with CKD. The kidneys' ability to excrete potassium is impaired in CKD, leading to elevated blood potassium levels (hyperkalemia), which can cause serious cardiac complications. Foods high in potassium, such as bananas, oranges, potatoes, and tomatoes, should be limited or avoided to help maintain safe potassium levels.
Choice c reason: Maintaining a low carbohydrate diet is not specifically recommended for clients with CKD. While managing carbohydrate intake is important, especially for clients with diabetes, the primary dietary focus for CKD patients is on controlling protein, potassium, sodium, and phosphorus intake. A balanced diet with appropriate nutrient management is key.
Choice d reason: Increasing intake of sodium-containing food is not appropriate for clients with CKD. Excess sodium can lead to fluid retention, hypertension, and increased strain on the kidneys. Clients with CKD are generally advised to follow a low-sodium diet to help manage blood pressure and reduce the risk of complications such as edema and heart failure.

Choice a reason: The patient uses clean technique when instilling the dialysate is incorrect and requires additional teaching. Peritoneal dialysis requires sterile technique to prevent infection. Using a clean technique, which is less rigorous than sterile technique, increases the risk of introducing pathogens into the peritoneal cavity. Proper sterile technique involves meticulous hand hygiene, using sterile gloves, and ensuring all equipment and supplies are sterile.
Choice b reason: The patient performs exchanges on a table with a sterile drape is appropriate. Using a sterile drape helps maintain a sterile field and reduces the risk of contamination during the dialysis procedure. This practice is an important part of sterile technique and helps ensure the patient's safety.
Choice c reason: The patient verbally expresses symptoms to report to the HCP is a positive behavior. Being aware of and communicating symptoms that may indicate complications, such as signs of infection or peritonitis, is crucial for timely intervention and management. This practice shows the patient is knowledgeable about monitoring their health and knowing when to seek professional help.
Choice d reason: The patient washes their hands before beginning is an essential step in both clean and sterile techniques. Proper hand hygiene is critical in preventing the spread of infection and is a fundamental practice in peritoneal dialysis. Washing hands thoroughly before starting the procedure helps minimize the risk of contamination.