Page 591 - Nutrition Essentials for Nursing Practice

C H A P T E R 2 1 Nutrition for Patients with Kidney Disorders 579

Box 21.2 STRATEGIES TO RELIEVE THIRST

■ Use ice or popsicles within the fluid allowance—very cold things are better at
relieving thirst.

■ Suck on hard candy or mints.
■ Chew gum.
■ Rinse your mouth without swallowing using refrigerated water.
■ Rinse your mouth occasionally with refrigerated mouthwash.
■ Suck on a lemon wedge.
■ Eat bread with applesauce or jelly with margarine.
■ Control blood glucose levels, as appropriate.
■ Try frozen low-potassium fruit, such as grapes.
■ Use small glasses instead of large ones.
■ Apply petroleum jelly to the lips.

people undergoing hemodialysis may need to limit their intake of fruits and vegetables to
those that are low in potassium. Despite the term “choice lists,” selections can be severely
limited. Tips for implementing nutrition therapy recommendations for CKD are featured
in Box 21.4.

Kidney Transplantation

Kidney transplantation is a treatment option for people with ESRD. As with all major
surgeries, the immediate postoperative diet is high in protein and calories to pro-
mote healing; nutrient needs gradually decrease after the initial postoperative period
(see Table 21.5). Most dietary parameters are removed when the new kidney func-
tions normally; side effects from immunosuppressant drugs may require some dietary
modifications (Beto and Bansal, 2004). A lifelong commitment to a “healthy” eating
is important to decrease the risk of obesity, hypertension, diabetes, and hyperlipidemia
and maximize bone density.

Box 21.3 STRATEGIES THAT MAY HELP PROMOTE DIETARY ADHERENCE
TO CKD DIET

■ Provide positive messages about what to eat rather than emphasizing food
restrictions.

■ Encourage social support from family and friends.

■ Foster the client’s perception as successfully adhering to the plan. People who are
more confident in their ability to adhere to the eating plan make better choices.

■ Provide feedback on self-monitoring and laboratory data. Correlation of records with
laboratory data enables the client to see cause and effect, reinforces the importance
of nutrition therapy, and opens the door for problem solving.

■ For clients who must restrict their intake of protein, encourage the use of low-protein
breads, cereals, cookies, and pastas. Acceptability varies greatly among low-protein
products, so if a client does not like one brand, it does not mean he or she will not
like another.