Patient on Hemodialysis

Renal Case StudyGraded AssignmentMr. G is a 47 y/o m adm w/ uncontrolled HTN. He had a h/o severe leg cramping about 12 mos ago when taking Lasix and his renal function was WNL at that time. Currently he is adm w/ s/o uremia i.e. nausea. He has not eaten anything in the last 5 days and UOP is scant~ 300 mL. Ht 5”10” UBW 225# CBW 215#. He has had an unintentional weight loss over the last 4 mos due to nausea and no appetite. Weight after his 1st HD session was 210#.Sign meds: Lasix. Epogen and Phos-loUpon admission his labs were as follows:Na 142Cl 9580Creat 7.2K 5.5TCO2 21Bl Sug 111Albumin 3.5H&H 11/33MCV 80RBC 3.7Urinalysis: +2 protein, low specific gravity and low pH.Adm I/O 960/500; Most recent I/O 1800/15001. Nutrition Diagnosis (PES statement)2. List the principles of the diet for a renal patient on hemodialysis.3. Convert 60 mEq K to mg4. Why would the protein restriction be if the pt was not on HD?4. On the next page, create a SOAP note for Mr. G using all of the previous history information.5. Calculate Mr. G’s BEE using the Harris-Benedict equation and the appropriate stress factor.6. Mr. G’s energy and protein requirements on hemodialysis are higher than his energy and protein requirements without hemodialysis. Explain why.7. The RD encouraged Mr. G to increase his caloric intake by eating more fat and sugar. Comment on the advantages vs. disadvantages of doing this with a patient who has renal disease.8. Using Mr. G’s last plan of MNT (1.3 g of protein per kg of IBW, 2 g Na, 90 mEq K, and 500 mL fluid + urinary output), plan a day’s menu using renal diet exchanges. Your textbook or your local diet manual would be good places to obtain renal exchanges.For more information on Patient on Hemodialysis check on:https://en.wikipedia.org/wiki/Hemodialysis

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