Nursing Nutrition Case Study # 21
Nursing Nutrition Case Study # 21
х and galidades endron’s brochure CASE STUDY #21 Dorothea is a 72-year-old black woman who is 5 ft 5 in tall and weighs 149 pounds. She has coronary heart disease and a long-standing history of hypertension with progressive loss of kidney function. She recently started receiving hemodialysis and is gaining about 4 pounds between treatments. She has convinced herself that because she is on dialysis, she can eat and drink whatever she wants and the machine will take care of it.” Yesterday, she ate the following: Breakfast: Lunch: Grits with cheese Bacon Biscuit with butter Coffee Hamburger on bun with ketchup and mustard Potato chips Banana Sweetened tea Fried chicken Macaroni and cheese Collard greens Pound cake Sweetened tea Pinner: What risk factors does Dorothea have for CKD? Based on her age, weight, and use of hemodialysis, what should the composition of her diet be (e.g., number of calories, grams of protein, grams of sodium)? Why is she gaining 4
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pounds between treatments? What is a more reasonable goal? What would you suggest she do to achieve the goal? Evaluate her protein intake and recommend changes she could make to achieve her protein goals. What foods is she eating that are not heart healthy? What substitutions would you recommend? Evaluate her sodium intake and recommend changes she could make to limit her sodium intake. What foods is she eating that are high in potassium? What alternatives would you suggest? What foods is she eating that are high in phosphorus? Is her calcium intake adequate? What would you tell Dorothea about the use of dialysis and her theory about eating anything she wants? Which is the lesser risk: getting enough calories and protein by eating non-heart-healthy foods or adhering to the sodium and other restrictions but not getting enough calories an protein? More Edit
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