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NCLEX Question of the Day
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A nurse is caring for a client with a new diagnosis of chronic kidney disease (CKD) Stage 4. Which statement by the client indicates a need for further teaching regarding dietary management?
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"I need to monitor my fluid intake carefully as prescribed."
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"I must avoid salt substitutes because they contain potassium."
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Correct answer "I need to increase my intake of protein to help my kidneys heal."
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"I should limit foods high in potassium, like bananas and potatoes."
Rationale
Clients with advanced CKD (Stage 4) typically need to restrict dietary protein intake. Damaged kidneys have difficulty excreting the nitrogenous waste products of protein metabolism (e.g., urea). High protein intake can increase the workload on the kidneys and worsen uremia. Protein intake is usually limited, but not eliminated, based on the client's specific condition and nutritional status, often guided by a renal dietitian. Increasing protein intake is contraindicated.
Limiting high-potassium foods is essential as failing kidneys cannot effectively excrete potassium, leading to hyperkalemia. Careful fluid monitoring and often restriction are necessary to prevent fluid overload. Salt substitutes often contain potassium chloride and should be avoided to prevent hyperkalemia.
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