Chapter 1, Problem D9CRE

Folic Acid Vitamin B6 Vitamin C Vitamin B12 14. What are the dietary recommendations for a dialysis patient? Calories Protein-HD- Potassium-HD- Phosphorus- PD-3000-4000mg/d 15. Should dialysis pts take fat-soluble vitamins why or why not? 16. Should patients take their B-complex vitamins prior to treatment? Why or why not? 17. What are the recommendations for physical activity? 18. What are some possible causes of low serum albumin? What are some possible dietitian Interventions? 19. What are some possible causes of dry weight loss? Dietitian intervention? 20. What are some possible causes of hyperkalemia? Dietitian Intervention? 21. What are some possible causes of hypokalemia? Dietitian Intervention? 22. What are some possible causes of hyperphosphatemia? Dietitian Intervention? 23. What are some possible causes of hypophosphatemia? Dietitian Intervention? 24. What are some possible causes of Hypercalcemia? Hypocalcemia? Dietitian Intervention? +Hypercalcemia- Hypocalcemia- Dietition…

Study Guide on anatomy, physiology and pathophysiology of kidneys (basics)

Renal Experience: Complete and turn into your weekly submission. Part 1: 1. Define the following terms related to renal nutrition: BUN b. Dry weight- Interdialytic wt. Gain (IDWG d CRF ARF f. nPCB- B PTH- h. Kt/v- Kinetic modeling Creatinine clearance 3. What are the main functions of the kidney? 4. List several causes of CRF 5. What is the difference between Hemodialysis (HD) and Peritoneal Dialysis (PD)? 6. What are the two different types of Peritoneal Dialysis? 7. How does the dialyzer/artificial kidney work? 8. What are some possible complications of HD? 9. What are some possible complications of PD? 10. What are some advantages of HD? 11. What are some advantages of PD? 12. Describe the differences between a graft, catheter, and fistula. Include pros and cons of each 13. List vitamin/mineral guidelines for dialysis patients. Sodium- Potassium HD- ♦Phosphorus- Calcium- Magnesium Water soluble vitamin supplementation to replace dialysate losses:

DaVita Dietitian Reference Manual Module 9 - Counseling Skills CASE STUDIES Case 1 Sandy is a 28 year old female patient who is new to dialysis and is having difficulty adjusting to her diagnosis of chronic kidney failure. She has poor vision as a result of poorly controlled diabetes for over 15 years. She has had excessive fluid weight gains between her first two treatments. What is your approach to counseling and what tools would you use? Case 2 Smiley is a 90 year old gentleman who is new to dialysis. He is hard of hearing and speaks little English. He lives with his wife who also has limited comprehension of the English language. His daughter states that he has a diagnosis of multiple myeloma. How would you plan for counseling Smiley about his new diet regimen and what materials would you use?

DaVita Dietitian Reference Manual Module 12--Peritoneal Dialysis CASE STUDIES Case 1 A 38 year old female patient with polycystic kidney disease is here for a clinic visit. She presents with the following labs: albumin 3.5, Hgb 12.1, Corrected Ca 10.8 (3rd time 10.2), Phosphorus 6.9, K 5.4. Her weight is 185 lbs and she is 6'1" tall. She reports a good appetite and weight has been stable. Two months ago, intact PTH was 1972. She has been counseled numerous times on the importance of controlling calcium and phosphorus, however, she loves milk and cheese. She is on Rocaltrol 0.25 mcg/day. She takes Renvela 800 mg as her phosphate binder, using 3 with meals and 2 with snacks, and she is adherent. Her nephrologist has just prescribed Sensipar 30 mg q dinner. What is your care plan for this patient and what nutritional counseling and patient education would you provide? Case 2 A 65 year old man, S/P heart transplant, Hepatitis C and six-month history on hemodialysis is beginning PD. He is…

DaVita Dietitian Reference Manual Module 12-Peritoneal Dialysis DISCUSSION QUESTIONS 1. Identify 3 advantages and 3 disadvantages of peritoneal dialysis compared to hemodialysis. 2. How do the nutritional needs of PD patients differ from those of HD patients? 3. What are the goals for Kt/V for PD?

DaVita Dietitian Reference Manual Module 12--Peritoneal Dialysis 1. 2 3. 4 5 6. 7. 8. 9. 10. REVIEW QUESTIONS True False With PD, there is a greater responsibility for patients to monitor their own dialysis than with hemodialysis. The higher the dextrose concentration in the PD solution, the more fluid removed and the more calories absorbed. PET testing is used to measure peritoneal dialysis adequacy. PD is contraindicated in diabetics due to the high glucose load of PD solutions. Malnutrition is prevalent among PD patients due to protein losses through the peritoneal membrane. This protein malnutrition contributes to increased morbidity and mortality. Sodium and phosphorus are restricted in the diet for PD patients, however potassium intake is usually more liberal than for HD patients. Protein losses are greater during peritonitis. The calories absorbed from dialysate are negligible. Insulin can be given intraperitoneally, if necessary. PD patients are at risk for high triglycerides…

DaVita Dietitian Reference Manual REVIEW QUESTIONS Module 8-Anemia Management True False 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. The renal vitamin should be taken daily and after dialysis on hemodialysis days. An adequate supply of vitamins B12, folate, and B6, as supplied by the renal vitamin, is needed for red blood cell production. The start dose for Epogen therapy is based on body weight and hemoglobin level. A patient's Iron Saturation (ISAT) is 15% and Ferritin is 95 ng/mL. This indicates absolute iron deficiency. A patient's Ferritin is 1200 ng/mL. This may be due to iron excess, infection, inflammation, or multiple transfusions. The healthy liver produces the hormone erythropoietin, necessary for red blood cell production in the bone marrow. A high normal or high MCV (close to or greater than 100 um³/cell) suggests a deficiency of B12 and/or folate. The DaVita Dietitian should reinforce taking the renal vitamin and timing it properly. The renal vitamin contains vitamin A in order to…

DaVita Dietitian Reference Manual Module 9-Counseling Skills REVIEW QUESTIONS 1. 2. 3. 4. 9 5. 6. 7. 8. 9. 10. True False It is not appropriate to sit down when counseling patients. It is appropriate to use small, less technical terms when educating patients. The environment or surroundings play a role in effective patient counseling. Renal diet education can be completed in one thirty-minute session. If a patient cannot communicate, it is acceptable to eliminate the diet instruction. It is not possible for a hemodialysis patient to follow a vegetarian diet. Using audiotapes or large print materials might be beneficial in educating patients with visual impairments. Frequently missed or shortened treatments are associated with increased morbidity and mortality. It is acceptable to label a patient 'noncompliant' in the medical record. Social and financial concerns have little effect on the patient's ability to adhere to the treatment regimen.