1. The client/caregiver will explain the role of sodium.
   1. Most dietary sodium is added to foods during cooking and processing.
   2. Sodium is absorbed by the intestines and excreted primarily by the kidneys.
   3. Increased levels of sodium in the body promote water retention and swelling.
2. The client/caregiver can explain when it is important to monitor sodium intake and sodium retention.
   1. Sodium is monitored to evaluate fluid- the electrolyte balance of the body.
   2. Cardiovascular disease and kidney disease will affect the body’s use of sodium.
   3. Sodium level testing is also used to monitor the effects of diuretic drug therapy.
   4. Diuretics are frequently used in the treatment of hypertension.
3. The client/caregiver can describe important concepts in a sodium-restricted diet.
   1. One teaspoon of table/cooking salt contains 2300 mg of sodium. The recommended amount of sodium for a healthy adult not on any sodium restrictions is 2400 mg of sodium daily.
   2. Restricted-sodium diets are often classified as
      1. No added salt—usually recognized as 4-g sodium diet.
      2. A low-sodium or restricted-sodium diet is usually a 2-g sodium (2-g Na) or 1-g sodium (1-g Na).
   3. Unseen sodium is in
      1. Over-the-counter medications such as antacids and laxatives
      2. Commercial beverages and bottled drinking water
      3. Toothpaste and mouthwash—do not swallow
      4. Processed foods, which yield the largest amount of sodium
4. The client/caregiver can list ways to reduce dietary sodium intake.
   1. Read labels. Sodium will be listed as an amount and as a percentage.
   2. Use food products with reduced sodium or no added salt.
   3. Use herbs, spices, lemon juice, and so forth instead of salt when cooking.
   4. Rinse foods such as tuna to remove some of the sodium.
   5. Remove salt from the table, and avoid adding salt to prepared food.
   6. Avoid condiments such as soy and teriyaki sauce and monosodium glutamate. Limit the usual condiments, such as mustard and ketchup.
   7. Eat fresh foods rather than canned or convenience foods.
   8. Limit cured foods such as bacon, ham, and hot dogs.
   9. Avoid foods packed in brine or pickled, such as sauerkraut, olives, and Pickles.
   10. Before using a “salt substitute,” check with a physician because many of these products have potassium instead of sodium. Salt substitutes are only for use at the table. If cooked, they may taste bitter.
   11. Use unsalted butter or margarine.
   12. Use low-sodium luncheon meats, cheeses, and peanut butter.
   13. Avoid organ meats, clams, lobster, crab, oysters, scallops, shrimp, and other shellfish.
   14. Read labels on ready-to-serve or convenience foods for sodium content.
   15. Information about the Dietary Approaches to Stop Hypertension Diet can be obtained at www.dash.bwh.harvard.edu. This diet plan promotes a diet rich in fruits, vegetables, and low-fat dairy foods and the use of fewer snacks and sugars.

Resources

American Diabetes Association
www.diabetes.org

American Heart Association
www.americanheart.org

My Pyramid—United States Department of Agriculture
www.mypyramid.gov

National Heart, Lung, and Blood Institute
www.nhlbi.nih.gov

National Institutes of Health
www.nih.gov

The Office of the Surgeon General
www.surgeongeneral.gov/sgoffice

References

Lutz, C., & Przytulski, K. (2001). Nutrition and diet therapy. Philadelphia: F. A. Davis Company.
Lutz, C., & Przytulski, K. (2004). Nutri notes: Nutrition &diet therapy pocket guide. Philadelphia: F. A. Davis Company.
Nutrition made incredibly easy. (2003). Philadelphia: Lippincott Williams & Wilkins.
Perry, A., & Potter, P. (2006). Clinical nursing skills & technique. St. Louis: Mosby Inc.
Taylor, C., Lillis, C., & LeMone, P. (2005). Fundamentals of nursing . Philadelphia: Lippincott, Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.