Application of the Nutrition Care Process: CKD Introduction Mrs. J is a 26-year-

Question

Application of the Nutrition Care Process: CKD Introduction Mrs. J is a 26-year-old Native American who presents with a history of renal insufficiency, hypertension, and type 2 diabetes mellitus. Her current symptoms include anorexia, nausea and vomiting, 4 kg recent weight gain, edema, shortness of breath, pruritus, and inability to urinate. She is admitted with a diagnosis of stage 5 CKD with plans to initiate hemodialysis. Medications: captopril, calcitriol, erythropoietin, vitamin mineral supplement, Glucophage. ANTHROPOMETRIC MEASUREMENTS Ht: 50% wt. : 170 lbs.; UBW 160-162 lbs. BIOCHEMICAL DATA Alb. 3.4 g/dL; Na 130 mEqL; K 5.6 mEqL, CI 91 mEqL; PO 9.5 mEqh; Mg 2.9 mEqL; BUN 69 mg/dL; Cr 12 mg/dl; Glucose 200 mg/dL; Hgb A, 8.9%. Nutrition Diagnosis 5. Identify at least two nutrition problems based on the 1. Define each of the patient's current symptoms. Explain nutrition assessment and medical history. Determine the diagnostic term for each nutrition problem. Next, identify the etiology of each nutrition problem. Finally, identify the signs and symptoms that support the evidence for these nutrition problems how they are related to chronic kidney disease 2. How are hypertension and type 2 diabetes mellitus related to her kidney disease? 3. Identify each of her medications. What is the rationale for Nutrition Intervention 6. Calculate the appropriate energy and protein 7. Write the complete nutrition prescription for this patient. 8. Select and list additional appropriate nutrition interventions. Nutrition Monitoring and Evaluation 9. Determine nutrition criteria for monitoring and evaluation each? Nutrition Assessment recommendations for Mrs.J FOOD-/NUTRITION-RELATED HISTORY Mrs. J states that she has a very poor appetite. Her 24-hour recall is as follows: Breakfast: dry toast, Pepsi 12 oz. Lunch: 1 oz ham sandwich on bun with 1 oz American cheese ced tea. Dinner: spaghetti sauce on 1 c.noodles, iced tea Assess her dietary intake and compare it to her 4. for each nutrition diagnosis that you identified

Explanation / Answer

Define each of the patient symptoms. Explain how they are related to chronic kidney disease?

How are hypertension and type II diabetes mellitus related to her kidney disease?

Hypertension:

Hypertension can harm veins in the kidneys, lessening their capacity to work appropriately. At the point when the power of blood stream is high, veins extend so blood streams all the more effectively. Inevitably, this extending scars and debilitates veins all through the body, incorporating those in the kidneys.

In the event that the kidneys' veins are harmed, they may quit expelling squanders and additional liquid from the body. Additional liquid in the veins may then raise circulatory strain much all the more, making a perilous cycle.

Type II diabetes:

With diabetes, the little veins in the body are harmed. At the point when the veins in the kidneys are harmed, her kidneys can't spotless her blood legitimately. Her body will hold more water and salt than it should, which can bring about weight pick up and lower leg swelling. She may have protein in her pee. What's more, squander materials will develop in her blood.

Diabetes additionally may make harm nerves in her body. This can cause trouble in exhausting her bladder. The weight coming about because of her full bladder can go down and harm the kidneys. Additionally, if pee stays in her bladder for quite a while, she can build up a disease from the quick development of microbes in pee that has a high sugar level.

Identify each of her medication. What is the rationale for each?

Captopril:

Captopril is an oral medication and an individual from a class of medications called angiotensin changing over chemical (ACE) inhibitors. ... Expert inhibitors are solutions that moderate (repress) the movement of the compound ACE and diminishing the generation of angiotensin II. Thus, veins broaden or expand, and circulatory strain is lessened.

Calcitriol:

The dynamic type of vitamin D ties to intracellular receptors that at that point work as interpretation components to balance quality articulation. Like the receptors for other steroid hormones and thyroid hormones, the vitamin D receptor has hormone-official and DNA-restricting areas.

Erythropoietin:

A negative criticism framework, in which tissue oxygenation controls Epo generation and Epo controls red platelet (RBC) creation, gives homeostasis in oxygen conveyance to body tissues. The objective cells for the activity of Epo are submitted erythroid ancestor cells, which have particular receptors for the hormone.

Vitamins and minerals:

Having ceaseless kidney infection changes her requirement for a few supplements. A portion of the reasons are:

Glucophage:

Its pharmacologic systems of activity are not quite the same as different classes of oralantihyperglycemic operators. Metformin diminishes hepatic glucose generation, diminishes intestinal assimilation of glucose, and enhances insulin affectability by expanding fringe glucose take-up and use.

Nutrition interventions:

Calculate the appropriate energy and protein recommendations for Mrs. J

In light of Mrs. J's dietary evaluation, the prescribed vitality and protein levels are:

Write the complete nutrition prescription for this patient:

Here is sample nutrition prescription of CKD patient:

Breakfast

Lunch

Dinner

Select and list additional appropriate nutrition interventions:

Breakfast

Lunch

Dinner

• Ziptop Omelet
• English biscuit or toasted bread
• Jam or jam, margarine or spread
• Fresh grapes
• Coffee or tea
• Sweetener or half and half

• Blackened shrimp pineapple plate of mixed greens
• Low-sodium wafers or fresh bread
• Lemon treats
• Lemon-lime pop

• Stuffed green peppers
• Dinner rolls
• Margarine or spread
• Stuffed strawberries
• Sparkling water

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