krystleforemanpurn — 2025-04-08 02:36:13 UTC

Pt is a 63 y.o. M with PMHx HTN, DM, CVD, and CKD V on HD 3x/week MWF who presents after 5 days missed HD. Pt with K+ 6.5, Phos 5.2 and Na+ 130. Admitted for emergent HD.

krystleforemanpurn — 2025-04-08 02:36:43 UTC

Which type of diet restrictions do you think are most appropriate for this patient? How could you reinforce the diet education that the RD might provide?

krystleforemanpurn — 2025-04-08 02:59:59 UTC

After 5 missed days of HD and no filtering of waste, this patient is showing signs of distress with elevated potassium levels which require immediate attention as they can can worsen this patients heart issues . Phosphorus levels are slightly elevated which could point to a worsening kidney function and Sodium levels are slightly low which means the fluid balance in the body is out of whack and can irritate this patients CVD, promote heart failure and could indicate excessive amount of fluid retained which is definitely a possibility since patient has missed 5 days of HD to help his already deteriorating kidneys. As an elderly man with a lot of chronic health issues it is not okay to miss even a day of HD and 5 is extremely dangerous. While in the Hospital, patient will probably require the DASH diet with a few alterations to help combat his CKD V, CVD, HTN, and DM. This patient will be given a fluid restriction as the body is already retaining too much water. Sodium will obviously be limited in the Dash diet and a push of more fruits, vegetables, whole grains and lean meats to combat the DM AND CVD. The elevated potassium and phosphorus levels will restrict foods like tomatoes, potatoes and dairy. Lean meats are okay but will also be limited to stop any further kidney strain from proteins. I can reinforce the education that an RD may provide by answering any questions they may have if family tries to bring them food or if they don't like what the kitchen brought up and want to know why their options are limited. If available I will also provide brochures that explain the dash diet and why its important

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