Which client situation requires the nurse to discuss the importance of avoiding foods high in potassium?
A. A 14-year-old who is taking diuretics.
B. A 16-year-old with ileostomy.
C. A 16-year-old with metabolic acidosis.
D. An 18-year-old who has renal disease.
Correct Answer: D. An 18-year-old who has renal disease.
Clients with renal disease are predisposed to hyperkalemia and should avoid foods high in potassium. Clients receiving diuretics, with ileostomies, or with metabolic acidosis may be hypokalemic and should be encouraged to eat foods high in potassium. Encourage intake of carbohydrates and fats and low potassium food such as pineapple, plums, strawberries, carrots, cauliflower, corn, and whole grains. Reduces exogenous sources of potassium and prevents metabolic tissue breakdown with the release of cellular potassium.
Option A: A client receiving diuretics may be hypokalemic. Encourage high potassium diet such as oranges, bananas, tomatoes, coffee, red meat, and dried fruits. Discuss the use of potassium chloride salt substitutes for a client receiving long-term diuretics.
Option B: Patients with ileostomies may have hypokalemia. Potassium may be replaced and level maintained through the diet when the client is allowed oral food and fluids. Dietary replacement of 40 to 60 mEq/L/day is usually sufficient if no abnormal losses are happening.
Option C: Patients with metabolic disease may be hypokalemic. Note for signs of metabolic alkalosis such as tachycardia, dysrhythmias, hypoventilation, tetany, and changes in mentation. These are usually associated with hypokalemia.
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