Question

The nurse is creating a plan of care for a client with chronic kidney disease and uremia. The nurse is developing interventions to assist in promoting an increased dietary intake while at the same time maintaining necessary dietary restrictions. Which action should the nurse include in the plan of care?

1) Increase the amount of protein in the diet.
2) Increase the amount of potassium in the daily diet.
3) Maintain a diet high in calories with frequent snacks.
4) Encourage the client to eat a large breakfast and smaller meals later in the day.

Answer 1

The most appropriate action for a nurse to include in the care plan of a client with chronic kidney disease and uremia is to maintain a diet high in calories with frequent snacks. This helps ensure adequate caloric intake without overwhelming the kidneys. Increasing protein or potassium in the diet is not recommended due to the risk of exacerbating renal dysfunction.

Step-by-step explanation:

The nurse planning care for a client with chronic kidney disease and uremia should maintain a diet high in calories with frequent snacks. It is important to manage dietary restrictions carefully in these patients, balancing the need to ensure adequate caloric intake without overburdening the kidneys. Therefore, the correct action to include in the plan of care would be to maintain a diet high in calories with frequent snacks (option 3), which helps the patient to meet their energy needs while avoiding large meals that can place excessive stress on the kidneys.

A diet for a patient with chronic kidney disease should be low in protein, low in sodium and limiting in potassium, as high levels of these can further damage the kidneys and exacerbate uremic symptoms. It's also beneficial to promote adequate hydration to aid in the production of urine and the excretion of waste products. While a large breakfast might seem appealing, it does not specifically assist in managing dietary restrictions for kidney health, making it a less suitable recommendation than frequent, small, nutritionally dense snacks.

It is imperative to avoid increasing the amount of protein (option 1) as this can lead to higher levels of urea that the damaged kidneys must filter, which can be hazardous. Increasing the amount of potassium (option 2) is also not advised due to the risk of hyperkalemia in renal failure. Specialty guidance from a dietician experienced in renal diets can be immensely beneficial in such cases, helping to tailor a meal plan that meets the patient's specific dietary needs while preventing further kidney damage.