What dietary instructions should the nurse give to parents of a child undergoing chronic hemodialysis? (Select all that apply.)
a. High protein
b. Fluid restriction
c. High phosphorus
d. Sodium restriction
e. Potassium restriction
ANS: B, D, E
Dietary limitations are necessary in patients undergoing chronic dialysis to avoid biochemical complications. Fluid and sodium are restricted to prevent fluid overload and its associated symptoms of hypertension, cerebral manifestations, and congestive heart failure. Potassium is restricted to prevent complications related to hyperkalemia; phosphorus restriction helps prevent parathyroid hyperactivity and its attendant risk of abnormal calcification in soft tissues. Adequate protein, not high intake, is necessary to maximize growth potential. Fluid limitations are determined by residual urinary output and the need to limit intradialytic weight gain.
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