A 2-gram sodium diet is prescribed for a client with severe hypertension. The client does not like the diet, and the nurse hears the client’s request that the spouse “Bring in some good home-cooked food.” It would be most effective for the nurse to plan to:
A. Call in the dietician for client teaching.
B. Wait for the client’s family and discuss the diet with the client and family.
C. Tell the client that the use of salt is forbidden, because it will raise BP.
D. Catch the family members before they go into the client’s room and tell them about the diet.
Correct Answer: B. Wait for the client’s family and discuss the diet with the client and family
Clients’ families should be included in dietary teaching; families provide the support that promotes adherence. Discuss the necessity for decreased caloric intake and limited intake of fats, salt, and sugar as indicated. Excessive salt intake expands the intravascular fluid volume and may damage kidneys, which can further aggravate hypertension.
Option A: Instruct and assist in appropriate food selections, such as a diet rich in fruits, vegetables, and low-fat dairy foods referred to as the DASH Dietary Approaches to Stop Hypertension) diet and avoiding foods high in saturated fat (butter, cheese, eggs, ice cream, meat) and cholesterol (fatty meat, egg yolks, whole dairy products, shrimp, organ meats).
Option C: Avoiding foods high in saturated fat and cholesterol is important in preventing progressing atherogenesis. Moderation and use of low-fat products in place of total abstinence from certain food items may prevent a sense of deprivation and enhance cooperation with a dietary regimen. The DASH diet, in conjunction with exercise, weight loss, and limits on salt intake, may reduce or even eliminate the need for drug therapy.
Option D: Review usual daily caloric intake and dietary choices. Identifies current strengths and weaknesses in dietary programs. Aids in determining an individual need for adjustment and teaching.
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