Editing Nutrition – RN Practice Questions (section)

==Question 4==
A client with end-stage kidney disease has just begun maintenance hemodialysis. Which statement by the client indicates correct understanding of the dietary plan?
# "Now that I am on dialysis I need to eat less protein than I did before."
# "Now that I am on dialysis I should eat more protein, such as eggs and chicken."
# "I can use a salt substitute freely now that dialysis removes my extra salt."
# "I should drink extra fluids on dialysis days to help flush out the toxins."

'''Answer:''' 2. "Now that I am on dialysis I should eat more protein, such as eggs and chicken."

''Rationale:'' Before dialysis, protein is restricted to roughly 0.6 to 0.8 g/kg/day to limit nitrogenous waste accumulation. Once hemodialysis begins, amino acids are lost into the dialysate with each treatment, and protein needs rise to approximately 1.2 g/kg/day of high-biologic-value protein. Option 1 reverses this relationship. Option 3 is dangerous: salt substitutes are potassium chloride, and a dialysis client cannot excrete a potassium load, risking fatal hyperkalemia. Option 4 is wrong because fluid is restricted, commonly to about 1000 mL/day plus urine output, and excess fluid causes interdialytic weight gain, hypertension, and pulmonary edema.