Sodium Restriction on the NCLEX
Hidden sodium, reading labels, and teaching a 2-gram diet people can actually follow.
Most dietary sodium never touches a salt shaker. Teaching a real 2-gram diet means teaching where it hides.
The numbers
General limit 2,300 mg/day; common cardiac and renal orders say 2 g (2,000 mg); tight restriction is 1,500 mg. One teaspoon of table salt is about 2,300 mg of sodium. Roughly 70% of intake comes from processed and restaurant food, not home cooking.
Label reading
Teach the definitions: sodium-free is under 5 mg/serving, very low sodium 35 mg or less, low sodium 140 mg or less. Reduced sodium only means 25% less than the original, which can still be high. Always check the serving size: a can of soup at 480 mg per serving with 2.5 servings in the can is 1,200 mg.
Teaching that survives contact with real life
Cook at home more, flavor with herbs, garlic, lemon, and vinegar, remove the shaker from the table, rinse canned vegetables and beans, choose fresh or frozen over canned and cured. Warn that taste adapts in a few weeks. Screen the med list before recommending salt substitutes: they are potassium chloride, contraindicated in CKD and risky with ACE inhibitors, ARBs, and spironolactone.
Frequently asked
Which lunch fits a 2-g sodium diet?
Grilled chicken with rice and fresh vegetables. The wrong answers will be a ham sandwich, canned soup, or a frozen dinner.
Does sea salt count as low sodium?
No. Sea salt, kosher salt, and table salt are all sodium chloride. The crystal size changes, the sodium does not.
Why restrict sodium in HF?
Sodium holds water. More sodium means more volume, more preload, more congestion, more dyspnea and edema.
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