Page 590 - Nutrition Essentials for Nursing Practice

578 U N I T 3 Nutrition in Clinical Practice

Box 21.1 SAMPLE CKD DIET: PREDIALYSIS AND WITH DIALYSIS

Sample CKD Predialysis (50 g Protein Diet) Sample CKD with Dialysis (90 g Protein Diet)

Breakfast ½ cup apricot nectar
½ cup apricot nectar 1 English muffin
1 English muffin 1 tbsp margarine
At least 1 tbsp margarine 2 eggs fried in margarine
Jelly Jelly
Coffee 1 cup coffee
Sugar Sugar
Nondairy creamer Nondairy creamer

Lunch Sandwich made with
Sandwich made with 4 oz turkey
2 slices whole wheat bread
2 oz turkey Salad dressing
2 slices whole wheat bread Lettuce and 1 slice tomato
Salad dressing
Lettuce and 1 slice tomato 1 small apple
1 small apple ½ cup low-fat milk
½ cup low-fat milk
4 oz roast beef
Snack Low-sodium gravy
2 fruit roll-ups ½ cup unsalted noodles with margarine
½ cup carrots
Dinner Lettuce, onions, cucumbers, green pepper
2 oz roast beef
Low-sodium gravy salad with olive oil and vinegar dressing
½ cup unsalted noodles with margarine ¹⁄8 blueberry pie
½ cup carrots with margarine 1 cup ginger ale
Lettuce, onions, cucumbers, green salad
Marshmallows, gumdrops, hard candy
with olive oil and vinegar dressing
¹⁄8 blueberry pie
Ginger ale

Snacks
Carbonated beverages*
Marshmallows, gumdrops, hard candy

*As allowed, depending on fluid needs.

to make permanent changes in eating habits and food choices can be an ongoing challenge.
Box 21.3 lists strategies that may help promote dietary adherence.

A “choice” system, similar to the diabetic exchange system, may be used to help
clients implement dietary restrictions. An individualized meal plan that corresponds as
closely as possible to the client’s food preferences and habits details the number of choices
permitted from each list for each meal. Portion sizes are specified to help ensure relative
consistency in nutrient intake. Table 21.6 shows choice lists with examples of representa-
tive foods. The composition and complexity of the choice list system differs with the type
of treatment used (e.g., predialysis, hemodialysis, or peritoneal dialysis). For instance,
people not receiving dialysis may not need to limit their intake of potassium and would be
free to choose among low-, medium-, and high-potassium fruits and vegetables, whereas