Page 598 - Nutrition Essentials for Nursing Practice

586 U N I T 3 Nutrition in Clinical Practice

NURSING PROCESS: Chronic Kidney Disease (continued)

Client Teaching Instruct the client on

1. The role of nutrition therapy in the treatment of CKD

2. Eating plan essentials including

■ Limiting protein, emphasizing high-quality proteins, spreading protein
allowance over the whole day

■ Consuming adequate calories

■ Limiting high-sodium foods, not adding salt during cooking or at
the table

■ Using sodium-free seasonings and salt alternatives to improve the
flavor of food

3. Behavioral matters including

■ How to weigh and measure foods to ensure accurate portion sizes

■ Self-monitoring protein intake

■ Weighing oneself at approximately the same time every day with the
same scale while wearing the same amount of clothing. Unexpected
weight gain or loss should be reported to the physician.

■ That renal diet cookbooks are available to increase variety

4. Changing eating attitudes

■ Learn to view the diet as an integral component of treatment and a
means of life support

■ Strict adherence to the diet can improve the quality of life and
decrease the workload on the kidneys

Evaluation

Evaluate and Monitor ■ Monitor weight
■ Monitor lab values, blood pressure, and urine output
■ Monitor appetite
■ Evaluate food records, if available
■ Provide periodic feedback and reinforcement

HOW DO YOU RESPOND?

Does cranberry juice prevent urinary tract infections? Cranberry has been found to
be effective against urinary tract infections by preventing bacteria from adhering to the
lining of the urinary tract, thereby promoting their excretion. However, the effects are
transitory, so regular, perhaps more than twice daily, intake is necessary. Clients who are
prone to urinary tract infections and like cranberry juice should be encouraged to
consume it regularly. Cranberry juice appears more effective than cranberry capsules or
tablets (Wang et al., 2012).

Are omega-3 fish oil supplements beneficial for people on hemodialysis? In addition
to their beneficial effects on the heart, supplements of omega-3 fats may help benefit
people on hemodialysis by preventing itching (uremic pruritus), decreasing vascular