Medical Surgical Kidney stones #4

Question

The nurse provides discharge instructions for a client who is diagnosed with oxalate renal calculi. Which client statement indicates understanding of the nurse’s instruction? Select the best answer.

Answers

  1. “I will eat moderate portions of fish and avoid liver and kidney meats.”
    • Rationale:

      This answer is not correct because these foods are purine foods and are indicated for clients who are advised to eat a low-purine diet. Low-purine diets are indicated for clients with gout or have too much uric acid in their bodies.

  2. “I will increase my intake of berries, chocolate and dark green veggies.”
    • Rationale:

      This answer is not correct because these are foods high in oxalate. The client is taught to decrease intake of oxalate foods; therefore, this client statement indicates a need for additional teaching.

  3. “I will decrease my intake of berries, chocolate and dark green veggies.”
    • Rationale:

      This answer is correct because this statement indicates an understanding of the dietary changes needed for reduction of oxalate renal calculi. Foods high in oxalates include fruits, vegetables, legumes, nuts, chocolate, soy and berries. Also, consuming more calcium can decrease the absorption of oxalate in the body and help prevent kidney stones from forming.

  4. “I will increase potassium-rich foods like bananas and avocados.”
    • Rationale:

      This answer is not correct because although low potassium intake impairs calcium reabsorption in the kidney, the nurse is instructing the client on oxalates and their relationship to kidney stones. For the client who experiences calcium oxalate stones, a low oxalate diet is encouraged.

Overview

Most kidney stones are composed of calcium, usually in the form of calcium oxalate. Clients with these types of kidney stones are encouraged to follow a low oxalate diet.

Explanation

Learning Outcomes

Oxalate is a substance made daily by the liver or absorbed from the client’s diet. Certain foods have high oxalate content. Foods high in oxalates include fruits, vegetables, legumes, nuts, chocolate, soy and berries. Also, consuming more calcium can decrease the absorption of oxalate in the body and help prevent kidney stones from forming. Limiting protein is important for dietary management of this type of kidney stone. Low potassium intake impairs calcium reabsorption within the kidney. This increases urinary calcium excretion, potentially causing hypercalcemia and kidney stones.

Test Taking Tip

Consider each statement as true or false regarding dietary intake and oxalate calculi and if more than one are true, choose the best answer.

Video Rationale