Medical Surgical Glomerulonephritis and Nephrosis #5

Question

A client admitted for glomerulonephritis has developed hypertension, oliguria, and azotemia. Which meal below would be most appropriate for this client?

Answers

  1. Baked chicken, cauliflower, graham crackers, and strawberries with water.
    • Rationale:

      This answer is correct because of the foods listed, it is the most low in protein, salt, and potassium. Baked chicken is a high protein food, so it would be best if the client was served a half serving (2 ounces). But the other foods, cauliflower, graham crackers, and strawberries are low in potassium, salt, and protein.

  2. Hot dog, baked chips and a banana with water.
    • Rationale:

      This answer is not correct because hot dogs have a high sodium and potassium content, as well as nitrogen compounds. Azotemia is when there is an excess of nitrogen compounds in the blood because the kidneys cannot get rid of the nitrogen waste. Bananas are high in potassium and though baked chips are a better option than regular chips, they still are an unhealthy option for a renal client.

  3. Grilled cheese sandwich, tomato soup and unsalted melba toast with water.
    • Rationale:

      This answer is not correct because most of these foods contain protein, sodium, and potassium. A client with azotemia needs to avoid foods that contain dairy due to the protein content, such as cheeses and milk. Unsalted melba toast is permitted since it is unsalted.

  4. Turkey sandwich, greek yogurt, celery with guacamole dip with water.
    • Rationale:

      This answer is incorrect because it is loaded with high protein and potassium. Greek yogurt has the highest amount of protein of the yogurts and avocado is a superfood packed with potassium.

Overview

Clients with hypertension, oliguria and azotemia should follow a renal diet. A renal diet consists of restrictions of protein, salt and foods high in potassium.

Explanation

Learning Outcomes

Clients with hypertension, oliguria and azotemia should follow a renal diet. A renal diet consists of restrictions of protein, salt and foods high in potassium. Protein restriction reduces the rate of glomerular sclerosis. Anyone with hypertension should always follow a low-salt/no salt diet due to the water retention sodium causes which in turn, increases blood volume. This encourages the heart to work harder, which then makes your blood pressure go up. Oliguria is reduced urine output. Inflammation of the glomeruli reduces the movement of fluid. In azotemia, the inflammation of the glomeruli prevents filtering and erection of urea. Having too much protein causes waste build-up and in a client with azotemia and oliguria, will have difficulty extracting that waste. This will also lead to hyperkalemia.

Test Taking Tip

Every nurse needs to know the nutrients in foods and the different types of diets that are permitted for certain disease processes.

Video Rationale