What is the accumulation of excess body fluids in cells, tissues, or several cavities, often causing swelling of extremities, such as hands, feet, legs and face?
______ is the most abundant intracellular cation?
Why is high blood potassium concentration considered to be a dangerous state?
high blood K+ concentration causes stress on the heart and can cause arrhythmias and heat attacks
How are the fluid needs of healthy adults estimated?
1 mL per Kcal
_____ is the branch of medicine studying kidney anatomy, physiology and pathology
_____ are specialists of the kidneys, their diseases, and medical management
______ is the general term referring to an abnormal conditon of the kidneys due to disease
______ is kidnet inflammation, which an be acute or chronic
_______ is when the renal tissue is hardened with reduced blood flow. It is often cause by hypertension
______ is an abnormal kidney condition causing clinical signs of edema, marked porteinuria, low blood albumin conc., and hyperlipidemia due to increased glomerular permeability as a result of glomerular injury
______ is a clinical state of severe glomerulonephritis with blood in urine, high blood pressure, and kidney failure (losing rbc in urine)
______ qualifies a state of excess urea in blood
_______ is an abnormally high amount of protein in urine
________ is the abnormal presence of albumin in the urine
_____ is the abnormal presence of blood or erythrocytes in the urine
_____ means high blood sodium concentration
______ means high blood potassium concentration
The _____ is the liquid collected after dialysis taht went through the selectively permeable membrane
The kidneys are responsible for maintaining blood pH at:
Which clients are susceptible to developing acture renal failure?
intensive care patients with multiple organ failures
What metabolic abnormalities are seen in clients with acute renal failure?
reduced urine production (oliguria, anuria)
blood electrolyte abnormalities (high blood K+, and P-)
abnormal fluid status (edema)
elevated blood urea
What type of diet is recommended for clients with acute renal failture?
proetin restriction (0.6-0.8)
(Although those on dialysis require high protein (1.2-1.5) for HD and (1/5-2.0 g/kg) for continuour renal replacement patients)
What factors should you keep in mind when making nutirional recommendations for clients with acute renal failure?
clients are very ill at first adn may not be able to eat (due to N&V)
the presence/degree of body protein catabolism in the client
the degree of clinical stress
the nutritional status of client
Explain the 5 stages of the development of CKD
1. There is damage to teh kidney's which causes proteinuria, but the GFR is still normal (or slightly elevated)
2. Kidney damage progesses and GFR is mildly decreased (60-89 mL/min)
3. The GFR is moderately decreased to 30-59 mL/min
4. The GFR falls below 30 mL/min (15-29)
5. ESRD, the GFR is <15 mL/min, which characterizes kidney failure (dialysis or transplantation is required)
What are metabolic and clinical consequences of CKD?
The kidneys become progressively less and less able to perform their normal physiological functions, including removing waste products from blood (urea/creatinine)
Symptoms caused by increased levels of urea in the blood/uremic symptoms?
What are two main goals of nutrition management for clients with pre-ESRD?
To help clients meet their nutirtional needs and maintian a good nutritional status
To provide nutrition education/counseling to help slow the progression of renal insufficiency, which will assist in preventing/maintaining metabolic complications
Diet recommendations for pre-ESRD
reduced in Pro, P, Na
may also need to be controlled in K, fluids, and energy to meet their individualized needs
energy should allow maintanence of a healthy body weight
What level of dietary protein restriction is usually required for clients with pre-ESRD
GFR 25-55 (0.75-0.8)
GFR <25 (0.6)
Recommmendations of Kcal, P, Na, Ca for clients wtih pre-ESRD
Energy: 35 kcal/kg (<60) and slightly less for older adults [if overweight: 20-30 kcal/kg; underweight: 45 kcal/kg]
Phosphorus: restricted to 0.8-1 g when serum P or PTH concentrations are elevated
Sodium: 1.0-3.0 g (~2g)
Potassium: not usually restricted, however K is based on individual serum K concentration, serum K is restricted when serum K is high and urin output is <1.1 qt)
Calcium: 1000-1500 mg (~1200mg) [no more than 2000 mg daily with phosphate binders]
When the GFR falls below 20 mL of blood per minute, blood_____ concentration increases, which inihibits vitamin ___ activation by the kidneys
The brain reacts by stimulating the secretion of ___ hormone, which increases blood Ca concentration by causing bone resorption. However, this leads to brittle bones and calcium depositions in soft tissues, causing more loss of renal function
the number one action to prevent renal osteodystrophy in clinets with chorinc renal insufficiency is to control blood ___ concentrations by restriciting dietary P and asking clients to take their ____ binder medication with food
Vitamin ___ supplementation is associated with toxicity in patients with chronic renal insufficiency
What are the goals of MNT for adult clients wtih NS who are not on dialysis
to assist clients in meeting their nutiritonal needs, replacing nutrientes lost, and maintaining a good nutritional status
to help reduce the metabolic complications of NS, including edema, proteinuria, and hyperlipidiemia and promote normalizing biochemical test values
Kidneys are important for the activation of vitamin ___
What is the main waste product of A.A catabolism
the two most common causes of CKD are:
hypertension and DM
Is the creatining height index useful to estimate muscle mass and protein-energy nutritional status in clients with pre-ESRD or ESRD
no, they aren't excreting creatinine, not useable for malnutiriton with renal patients
Do high-Pro diets cause CRF
no, there is no evidence
Tops to control fluid intake
limit high salt foods
drink from small glasses
drink only when thirsty
swish water/fluid around in mouth
use sour-candies or sugar free gum
place allowed amount of water in pitcher and each time you drink, empty out the amount drank from pitcher (visual aid)
A low-Pro, low-phosphorus diet is recommended for clients with pre-ESRD for the following reasons: