The nurse plans a therapeutic diet for a client with congestive heart failure. Which should the nurse include in the client's diet to facilitate excretion of fluid?

Question

1. Fresh fruit
2. Daily fiber
3. Egg whites
4. Lean protein

Answer 1

1
1. The nurse includes fresh fruit in the client's diet to facilitate fluid excretion be-cause fruit is a food choice that is low in sodium and sodium is a major factor deter-mining serum osmolality. Clients with heart failure retain fluid and usually take di-uretics to excrete excessive fluid daily, decrease the myocardial workload from ex-cessive preload, and reduce hypertension; however, diuretic therapy has inherent risks including electrolyte imbalance. To reduce the need for diuretics, the client limits sodium intake because where sodium goes, water follows. If the client's serum has a relatively low sodium concentration, the serum is less able to hold water in the intravascular space and the client, subsequently, urinates the excess water.
2. The nurse includes adequate dietary fiber to maintain elimination.
3 and 4. The nurse includes lean sources of protein including fish, egg whites, and chicken to provide amino acids for tissue repair and substrate for hemoglobin pro-duction. The nurse avoids providing protein with high amounts of saturated fat to help control serum lipid levels.