Food and Nutrition Related Knowledge Deficit of client on Hemodialysis
Total years in practice: 10
Height: 160 cm
Weight; 60 kg (dry weight
Body Mass Index (BMI): 23.44 kg/m2
Weight Status: Normal
Blood Pressure: 120/80 mmHg
Medications: Amlodipine, Erythropoietin, Vitamin B complex, Folate, Magnesium Hydroxide
Diet History: The patient is fond of eating fast-food three times a week, consumes red meat almost every day, fish twice a week, vegetables every day, and lots of fruits. The patient has a food and nutrition-related knowledge deficit.
The patient is hypertensive for 8 years, is currently on Chronic Kidney Disease Stage 5 and is on chronic hemodialysis, twice a week.
Identified Nutrition Problem: Food and Nutrition Related Knowledge Deficit
> The patient was given a comprehensive nutrition counseling on the prescribed diet: 1800 Calories/day, low sodium, low fat, low cholesterol, low potassium (<2 grams Potassium), 72 grams total protein.
> Instructed to limit consumption of Potassium-rich foods such as fruits. Limited fruit intake to one serving per day.
> The patient was given a meal plan, diet guides, and the food distribution are as follows:
1. Rice exchanges - 9 servings daily
2. Meat exchanges(preferably white meat to limit kidney toxins) - 6 servings daily of fish and white meat
3. Fruit exchange - 1 serving daily
4. Vegetable exchange - 4 servings daily
5. Fat exchange - 9 servings daily
> Instructed to Avoid foods high in Phosphorus as this may increase kidney load
Foods High in Phosphorus and their Phosphorus content;
1. I cup Milk and one serving of Dairy Products - 200-230 mg
2. 1 pc Avocado - 100 mg
3. 3ounce Organ meats - 350 mg
4. 1/2 cup Nuts - 280 mg
5. 1/2 cup Processed meats - 110-340 mg
6. 12 ounce Cola Beverages - 60 mg
7. Baked goods per 100grams - 430-9918 mg
8. 1/2 cup Seafoods - 274-490 mg
> Total Fluid Requirement: 1000 mL/day
> Instructed to read labels of foods and food products to look for nutrient content. Look for Sodium content of less than 400mg per serving
Foods with High Sodium Content to Avoid:
1. Canned goods
2. Salted nuts
3. Frozen meats and processed meats
4. Instant noodles
5. Fast Foods
6. Pickled Products
7. Junk foods
8. Excess seasoning
9. Processed Cheese
> Encouraged to be creative and to season foods with herbs, spices, pepper, lemon, garlic, vinegar among others
> Encouraged to have Omega 3 fatty acid supplement for its anti-inflammatory benefits.
MONITORING AND EVALUATION
The patient was monitored every 3 months. The patient followed his diet recommendation well and his weight has been maintained ever since. His blood pressure is always controlled since he was guided by his diet.