Exam (elaborations)
Nutrition Exam -5 Renal & GI (Chapters 23-25, Highlight 24) Questions and Answers
Institution
Renal Nutrition
Nutrition Exam -5 Renal & GI (Chapters 23-25, Highlight 24) Questions and Answers
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Nutrition: Exam #5: Renal & GI (Chapters
23-25, Highlight 24) Questions and
Answers
What iiare iithe iifunctional iiunits iiof iithe iikidneys iicalled? ii- iiAnswers ii-nephrons
The iikidneys iiactivate iiwhich iivitamin? ii- iiAnswers ii-Vitamin iiD
What iihormone iisecreted iiby iithe iikidneys iistimulates iithe iiproduction iiof iired iiblood
iicells? ii- iiAnswers ii-erythropoietin
The iiconsequences iiof iinephrotic iisyndrome iiinclude? ii- iiAnswers ii-- iiEdema
- iiblood iilipid ii& iiblood iiclotting iiabnormalities ii
- iidepletion iiof iiimmunoglobulins ii(increases iisusceptibility iito iiinfection
- iiloss iiof iiVitamin iiD iibinding iiprotein ii(results iiin iilower iiVit. iiD ii& iicalcium iilevels,
iiincreasing iirisk iiof iirickets iiin iichildren)
- iiprotein iienergy iimalnutrition ii(PEM) ii
- iimuscle iiwasting iimay iidevelop
Daniel iiis iia ii10-year-old iiboy iithat iihas iijust iibeen iidiagnosed iiwith iinephrotic iisyndrome.
iiHe iiis iiat iiincreased iirisk iiof iithe iibone iidisease ii_____. ii- iiAnswers ii-Rickets
Nutrition iitherapy, iias iia iitreatment iifor iinephrotic iisyndrome, iifocuses iion___, ii___, iiand
ii___. ii- iiAnswers ii-Prevent iiPEM, iialleviate iiedema, ii& iicorrect iilipid iiabnormalities
For iipatients iiwith iinephrotic iisyndrome, iithe iirecommended iidaily iiprotein iiintake iiis ii__
iito ii__/kg iibody iiweight ii- iiAnswers ii-0.8-1.0 iig/kg iiof iibody iiweight/day
Oliguria iiis iithe iiterm iito iidescribe iidiminished iiurine iioutput, iioften iiless iithan ii___
iimL/day. ii- iiAnswers ii-400 iimL/day
What iiranges iiof iiprotein iiintake iiare iirecommended iifor iia iipatient iiwith iilimited iikidney
iifunction iiwho iiis iinot iitreated iiwith iidialysis? iiFor iipatients iion iiHD iior iiPD? iiThis
iirequires iithat iiyou iiknow iiyour iistages iiof iichronic iikidney iidisease ii- iiAnswers ii-Limited
iiKidney iiFunction iiNot iiTreated iiwith iiDialysis: ii0.8-1.0 iig/kg iiof iibody iiweight/day
HD/PD: ii1.0-1.7 iig/kg/day
Uremia iidevelops iiduring iithe iifinal iistages iiof iiCKD iiwhen iiGFR iiis iibelow ii_____
iimilliliters iiper iiminute iiand iiblood iiurea iinitrogen iiexceeds ii_____ iimilligrams iiper
iideciliter. ii- iiAnswers ii-GFR ii<15 iimL/minute
,BUN: ii>60 iimg/dL
Uremic iisyndrome iiclinical iieffects iiinclude? iiBe iiable iito iiunderstand iiand iidescribe
iithese. ii- iiAnswers ii-- iialtered iimental iistatus
- iineuromuscular iichanges: iimuscle iicramping, iitwitching
- iiimpaired iihormone iisynthesis: iierythropoietin ii- iianemia; iireduced iiproduction iiof
iivitamin iiD ii→ iibone iidisease
- iibleeding iiabnormalities: iidefects iiin iiplatelet iifunction ii& iiclotting iifactors iialong iiw/ iiskin
iichanges
- iicardiovascular iidisease iirisk: iiHTN, ii↑ iiinsulin iiresistance, ii& iiabnormal iiblood iilipids
- ii↓ iiimmunity ii- iipoor iiimmune iiresponse ii- iiprone iito iiinfection, iia iifrequent iicause iiof
iideath
True iior iiFalse: iiThe iipatient iiwith iiCKD iiwill iioften iipresent iiwith iianemia, iidiabetes,
iiPEM, iimetabolic iistress/infection iiwhich iiwill iialter iinutritional iistatus. ii- iiAnswers ii-True
Patients iishould iibe iiadvised iithat iiwhich iiof iithe iifollowing iifoods iicontribute iito iithe iifluid
iiallowance iiin iifluid-restricted iidiets?
a. iiGelatin/Jello ii
iib. iiPopsicles ii
iic. iiSherbet ii
iid. iiFruit iiice ii
iie. iiIce iicream ii- iiAnswers ii-all iiof iithem, iibecause iithey iiall iimelt ii& iiturn iiinto iiliquid
Gelatin/Jello; iiPopsicles; iiSherbet; iiFruit iiice; iiice iicream
Name iiseveral iiways iithe iihealth iipractitioner iican iiassess iifluid iistatus iiin iithe iipatient
iiwith iikidney iidisease ii- iiAnswers ii-Monitoring iiweight iifluctuations, iiblood iipressure,
iipulse iirates, ii& iiappearance iiof iithe iiskin ii& iimucous iimembranes. iiAdditionally, iilooking
iiat iithe iiserum iisodium iilab: iilow iisodium ii= iiexcessive iifluid iiintake ii// iihigh iisodium ii=
iiinadequate iifluid iiintake
Once iia iiperson iiis iion iidialysis, iisodium iiand iifluid iiintakes iishould iibe iicontrolled iiso
iithat iionly iiabout ii____ iilbs iiof iiwater iiweight iiare iigained iidaily. ii- iiAnswers ii-2.2 iilbs
Intakes iiof iisupplemental iivitamin iiC iiare iirestricted iiin iipatients iiwith iichronic iirenal
iifailure iito iiprevent? ii- iiAnswers ii-risk iifor iikidney iistones
A iifactor iithat iipredisposes iipeople iito iikidney iistone iiformation iiis? ii- iiAnswers ii--
iidehydration
- iilow iiurine iivolume
- iichanges iiin iiurine iiacidity
- iimetabolic iiabnormalities
, - iiobstruction
- iirenal iidisease
What iifoods/practices iicontribute iito iihigh iiuric iiacid iilevels? ii- iiAnswers ii-- iianimal
iiprotein
- iiinadequate iiwater iiintake
- iialcoholism
- iihigh iifructose iicorn iisyrup ii(HFCS)
- iicrash iidiets
- iishellfish
- iiorgan iimeats ii(liver)
- iisoft iidrinks
To iiregulate iiblood iipressure, iithe iikidneys iisecrete iiwhat? ii- iiAnswers ii-renin
Where iidoes iithe iimajority iiof iisodium iicome iifrom iiin iia iitypical iidiet? ii- iiAnswers ii-
processed iifoods
Describe iithe iievents iileading iito iithe iidevelopment iiof iibone iidisease iiin iipatients iiwith
iiCKD ii- iiAnswers ii-LOSS iiOF iiFUNCTIONAL iiKIDNEY iiTISSUE ii→ iidecreased
iiactivation iiof iivitamin iiD ii& iidecreased iiphosphate iiion iiexcretion ii→ iidecreased iicalcium
iiabsorption iifrom iiintestines ii& iiincreased iiserum iiphosphate→ iiDECREASED iiSERUM
iiCALCIUM ii→ iistimulates iiparathyroid iihormone iisecretion ii→ iiincreased iicalcium
iiresorption iifrom iibone ii→ iiincreased iiserum iicalcium ii& iiphosphate iideposits iiin iitissue
ii& iiBONE iiDEMINERALIZATION ii→ iidecreased iibone iimass, iispontaneous iifractures,
ii& iirenal iirickets iiin iia iichild
AKI iiDietary iiGuidelines ii- iiAnswers ii-- iiProtein ii- ii0.8-1.0 iigrams iiper iikg iibody
iiweight/day ii(NON-DIALYSIS)
ii→ iiHigher iiintakes iionce iikidney iifunction iiimproves, iithe iipatient iiis iicatabolic, iior
iitreatment iiincludes iidialysis ii(1.2-1.7 iig/kg/day)
- iiCalories ii20-30 iical/kg iibody iiweight/day
- iiFluids ii- iimeasure iiurine iioutput iiand iiadd ii400-600 iimL iito iiaccount iifor iiinsensible
iiwater iilosses.
ii→ iiDialysis ii- iifluid iiallowance iiliberalized
ii→ iiMonitor iifluid iistatus
- iiElectrolytes ii-serum iielectrolytes iimonitored iito iidetermine iirestrictions ii(potasslum,
iisodium, iiphosphorus)
- iiEnteral iiand iiparenteral iinutrition ii- iiStandard iiformulas iiare iirecommended, iialthough
iia iispecialty iiformula iidesigned iifor iirenal iifailure iimay iibe iiconsidered iiin iipatients
iideveloping iisignificant iielectrolyte iiabnormalities.
Dietary iiGuidelines iifor iipatients iiwith iiChronic iiKidney iiDisease ii(CKD) iiNOT iion
iiDialysis ii- iiAnswers ii-CKD iiPre-Dialysis: ii
ii→ iiProtein ii0.6-0.75 iig/kg/day ii(≥50% iiHBV)
ii→ iienergy ii30-35 iical/kg/day