A male client who has been treated for chronic renal failure (CRF) is ready for discharge. Nurse Billy should reinforce which dietary instruction?
A. “Be sure to eat meat at every meal.”
B. “Monitor your fruit intake, and eat plenty of bananas.”
C. “Increase your carbohydrate intake.”
D. “Drink plenty of fluids, and use a salt substitute.”
Correct Answer: C. “Increase your carbohydrate intake.”
In a client with CRF, unrestricted intake of sodium, protein, potassium, and fluid may lead to a dangerous accumulation of electrolytes and protein metabolic products, such as amino acids and ammonia. Therefore, the client must limit intake of sodium; meat, which is high in protein; bananas, which are high in potassium; and fluid, because the failing kidneys can’t secrete adequate urine.
Option A: The amount of protein the client should have depended on his body size, activity level, and health concerns. Some doctors recommend that people with kidney disease limit protein or change their source of protein. This is because a diet very high in protein can make the kidneys work harder and may cause more damage.
Option B: Healthy sources of carbohydrates include fruits and vegetables. Unhealthy sources of carbohydrates include sugar, honey, hard candies, soft drinks, and other sugary drinks. Some carbohydrates are high in potassium and phosphorus, which the client may need to limit depending on his stage of kidney disease.
Option D: Sodium (salt) is a mineral found in almost all foods. Too much sodium can make the client thirsty, which can lead to swelling and raise blood pressure. This can damage the kidneys more and make the heart work harder. Salt substitutes are high in potassium and should be avoided. Extra carbohydrates are needed to prevent protein catabolism.
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