Mrs. F asks the nurse about the need for vitamin supplementation for her husband who is on dialysis. She would like to give her husband a multivitamin twice a day since his appetite is not good. The best response for the nurse would be:
1. "Your husband should not need extra fat-soluble vitamins because they are not removed by dialysis.".
2. "Vitamins are not toxic and extra amounts will not cause harm.".
3. "All water-soluble vitamins are removed by dialysis.".
4. "The most common vitamin deficiency is B12, so only give him that.".
1
Rationale: Fat-soluble vitamins are not removed during dialysis and should not need to be replaced. There can be some deficiencies in water-soluble vitamins and there is some evidence that one multivitamin a day may be beneficial, but there are no recommendation for more than one a day. Excess amounts of vitamins are not recommended and can be harmful. Not all water-soluble vitamins are lost during dialysis. Vitamin B12 is protein bound and not removed by dialysis.
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