護理師正在指導一位慢性腎臟病(CKD)病人進行低磷飲食。哪些食物選擇顯示病人理解了指導內容?(選所有適合的)
A nurse is teaching a client with chronic kidney disease (CKD) about a low-phosphorus diet. Which food choices indicate that the client understands the instructions? (Select all that apply.)
- AFresh poultry✓ 正解新鮮家禽肉類
- BProcessed deli meats加工熟食肉品
- CHard cheeses硬起司
- DWhite bread✓ 正解白麵包
- ESherbet (non-dairy frozen dessert)✓ 正解雪酪(非乳製冷凍甜點)
在慢性腎臟病中,磷的排泄減少會導致高磷血症,進而引發骨質病變。低磷飲食是管理的關鍵。高磷食物包括乳製品(起司、牛奶)、加工食品(含磷酸鹽添加物)、全穀類、堅果與內臟。病人應選擇磷含量較低的食物:新鮮肉類(優於加工肉)、精製澱粉(白麵包磷含量低於全麥)、以及非乳製品甜點(如雪酪)。加工肉品(B)和硬起司(C)是高磷地雷。衛教重點在於辨識「隱形磷」(加工添加物),因為這類磷的吸收率極高,對腎臟負擔最大。
Fresh poultry, white bread, and sherbet are appropriate choices because they contain lower levels of phosphorus compared to processed meats, hard cheeses, and whole grains. Processed foods often contain inorganic phosphate additives that are highly absorbed, while fresh meats contain organic phosphorus that is less readily absorbed. Selecting these options helps manage hyperphosphatemia and reduces the risk of bone disease in clients with chronic kidney disease.
美國對於食品標示要求雖嚴,但磷酸鹽添加物常隱藏在成分中,護理師會教病人找 'PHOS' 關鍵字;台灣臨床營養衛教常強調「鮮奶替代品」,且會教導病人如何正確使用磷結合劑(隨餐嚼碎)。