A nurse is preparing a teaching plan for a client who is starting to receive hemodialysis for chronic kidney disease. Which of the following instructions should the nurse include in the teaching?

Rationale: A. "Use salt substitutes to reduce your sodium intake.": Salt substitutes often contain potassium, which can accumulate to dangerous levels in clients with chronic kidney disease. Therefore, they should be avoided rather than recommended. B. "Increase your fluid intake to 1,000 mL a day.": Clients on hemodialysis typically require fluid restrictions, not increases, to prevent fluid overload between dialysis sessions. Fluid allowances are individualized based on urine output and clinical status. C. "Include phosphorus-rich foods in your diet.": Phosphorus levels tend to rise in clients with kidney failure, contributing to bone disease. These clients are advised to avoid phosphorus-rich foods like dairy, nuts, and cola beverages. D. "Avoid food products that contain trans-fats.": Clients with chronic kidney disease are at increased risk for cardiovascular disease. Avoiding trans-fats, which raise LDL cholesterol and promote inflammation, supports heart health and is an appropriate dietary recommendation.