The nurse is caring for a client from another country who was admitted with chronic renal failure and is on hemodialysis. Which of the following statements indicates to the nurse the need for further teaching?
1. "I will report any increase in my weight of 5 pounds or more in a 2-day period.".
2. "I take my prescribed antihypertensive drugs daily.".
3. "I am careful to take precautions in the arm with the AV fistula.".
4. "I comply with salt restrictions in my diet by using salt substitutes.".
4. "I comply with salt restrictions in my diet by using salt substitutes.".
Rationale: Many salt substitutes use potassium chloride. Potassium intake is carefully regulated in clients with renal failure, and the use of salt substitutes will worsen hyperkalemia. Increases in weight do need to be reported to the health care provider as a possible indication of fluid volume excess. The control of hypertension is essential in the management of a client with renal failure. An AV fistula does need to be protected from injury that could be caused by constricting clothing, venipunctures, and other items.
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