what dietary recommendations should be given to a patient with pre dialysis end stage kidney disease

ATI RN

ATI Capstone Adult Medical Surgical Assessment 2

1. What dietary recommendations should be given to a patient with pre-dialysis end-stage kidney disease?

A. Reduce phosphorus intake to 700 mg/day
B. Increase sodium intake
C. Increase protein intake
D. Increase potassium intake

Correct answer: A

Rationale: The correct recommendation for a patient with pre-dialysis end-stage kidney disease is to reduce phosphorus intake to 700 mg/day. High phosphorus levels can lead to complications in such patients. Increasing sodium intake (Choice B) is generally not recommended due to its association with hypertension and fluid retention. While protein is essential, increasing protein intake (Choice C) in kidney disease can be harmful as it can lead to increased waste products that the kidneys may struggle to excrete. Increasing potassium intake (Choice D) is not advisable as well, as patients with kidney disease may already have difficulty excreting potassium, leading to hyperkalemia.

2. A nurse is teaching a client who has hypertension about dietary modifications to help control blood pressure. Which of the following food choices should the nurse recommend as the best choice for the client to include in their diet?

A. 1 packet of reconstituted dry onion soup
B. 3 oz of lean cured ham
C. 3 oz of chicken breast
D. ½ cup of canned baked beans

Correct answer: C

Rationale: For a client with hypertension, a low sodium diet is recommended to help control blood pressure. Among the food choices provided, the best option is 3 oz of chicken breast. Chicken breast is lean protein with lower sodium content compared to other choices. It is a healthier option for managing hypertension. Reconstituted dry onion soup (Choice A) and canned baked beans (Choice D) typically contain higher amounts of sodium, which can be detrimental for blood pressure management. Lean cured ham (Choice B) also tends to have a higher sodium content, making it less suitable for a client with hypertension.

3. A patient with ventricular tachycardia and a pulse needs electrical intervention. What is the appropriate action?

A. Defibrillation
B. Synchronized cardioversion
C. Pacing
D. Medication administration

Correct answer: B

Rationale: For a patient with ventricular tachycardia and a pulse, the appropriate action is synchronized cardioversion. Defibrillation is used for pulseless ventricular tachycardia or ventricular fibrillation. Pacing is typically used for bradycardias. Medication administration may be considered in stable ventricular tachycardia cases but electrical intervention is preferred for immediate correction in this scenario.

4. What symptoms are expected in a patient with compartment syndrome?

A. Unrelieved pain, pallor, and pulselessness
B. Localized swelling and numbness
C. Fever and infection
D. Weakness and fatigue

Correct answer: A

Rationale: In a patient with compartment syndrome, the key symptoms include unrelieved pain, pallor, and pulselessness. These symptoms indicate reduced circulation in the affected compartment. Choice B is incorrect as localized swelling and numbness are not typically associated with compartment syndrome. Choice C is incorrect as fever and infection are not primary symptoms of compartment syndrome. Choice D is incorrect as weakness and fatigue are not typically seen in compartment syndrome.

5. What is the purpose of an escharotomy?

A. To relieve pressure and improve circulation in burn injuries
B. To reduce pain in the affected area
C. To remove necrotic tissue from a wound
D. To prevent infection from spreading

Correct answer: A

Rationale: An escharotomy is performed to relieve pressure and improve circulation in areas affected by deep burns. This procedure helps prevent complications such as compartment syndrome by releasing the constricting eschar. Choice B is incorrect because while pain relief may be a secondary outcome of the procedure, the primary purpose is to address pressure and circulation issues. Choice C is incorrect as an escharotomy specifically focuses on releasing pressure, not removing necrotic tissue. Choice D is incorrect as the primary goal of an escharotomy is not to prevent infection but rather to address the immediate issues related to deep burn injuries.