CHAPTER 14: RENAL DISORDERS

Question 1

What education/NI should be provided to a patient experiencing CKD?

Answer 1

o Limit protein intake to 0.8-1 g/kg/day if stage 1-4 but if on dialysis increase to 1.2-1.5 g/kg/day
o Limit phosphorus intake
▪ Limiting intake of dairy, dark green vegetables, meat, fish, eggs, legumes, cola, chocolate, and beer.
o Limit potassium intake***
▪ Bananas, potatoes, tomatoes, oranges, cantaloupe, avocado, dark green vegetables
o Limit sodium intake
▪ Taking in a lot of sodium, water always follows → increase BP
o Meat intake: F <4oz/day; M <6oz/day
o Avoid herbal supplemental that affect bleeding time (i.e., gingko) or BP
o May need Ca supplements

Question 2

What education/NI should be provided to a patient experiencing ESRD (pt’s who have moved past CKD and are receiving dialysis?)

Answer 2

o Encourage higher protein intake
o A lot are the same for CKD
▪ Limit phosphorus intake
▪ Limit potassium intake
▪ Limit sodium intake
▪ Limit fluid intake
o Provide calcium and vitamin D supplements

Question 3

What education/NI should be provided to a patient experiencing AKI?

Answer 3

1. Oliguric
   a. Restrict fluid intake to the (daily urine
   output) + 500 mL
2. Diuretic
3. Recovery
   o Limit protein intake for those not receiving dialysis
   ▪ 0.6 g/kg/day
   o Dialysis= more protein (because of protein loss)
   ▪ 1-1.5 g/kg/day
   o Potassium and Sodium intake= depends on the phase of AKI
   o 20-30 cal/kg/day in all stages

Question 4

What education/NI should be provided to a patient experiencing nephrotic syndrome?

Answer 4

o Sufficient protein intake
     ▪ 0.7-1 g/kg/day
▪ Emphasis on Soy based protein**
o Low sodium diet (< 2 g/day)
o Carbs as majority of calories
o Restrict fats
o Multivitamins

Question 5

What education/NI should be provided to a patient experiencing Nephrolithiasis (kidney stones)?

Answer 5

▪ Increase fluid intake
• 2-3 L per day
▪ Decrease intake of animal protein, sodium, alcohol, caffeine

Question 6

What are the r/f for Nephrolithiasis?

Answer 6

▪ Too much protein
▪ Too much sodium
▪ Too much calcium
▪ Too much oxalate
▪ Inadequate fluid intake

Question 7

What foods should be avoided for kidney stones made of calcium oxalate?

Answer 7

• Spinach
• Rhubarb
• Strawberries
• Beats
• Chocolate
• Nuts
• Tea

Question 8

What foods should be avoided for kidney stones made of uric acid?

Answer 8

limit foods high in purines
• Meat
• Whole grains
• Legumes