15.4: Implement Nutritional Strategies to Impact Renal Wellness
By the end of this section, you should be able to:
- 15.3.1 Assess the client for readiness to learn.
- 15.3.2 Teach nutritional strategies to optimize renal wellness.
Holistic Nursing Assessment of the Client
When providing holistic care, the nurse should address potential barriers the client may face in accessing healthy foods. According to the World Health Organization , 30–55% of health outcomes are influenced by social determinant health disparities such as economic stability, food security, social context, and environment, among others (Reinoso et al., 2022; World Health Organization, 2020). Many of the fresh foods recommended on a customized nutritional plan for renal disease are often more expensive and harder to obtain than packaged or processed foods. To set the client up for success in following the plan, the nurse should inquire about any food security issues the client has. The nurse should create a plan that addresses the client’s insecurities and further support the client by connecting them to the appropriate resources.
The nurse should refer clients to one of the multiple government programs available to help with food security issues.
Client Teaching
Client adherence to the nutritional plan may also be difficult if they are lacking education or fail to engage in a plan. If the client does not understand diet restrictions or the need to follow them, they are not likely to follow the prescribed diet. Client and family or caretaker engagement in the planning of their diet and in the active learning process is considered essential to success—engaged clients are more likely to be proactive in the management of their condition and they are more likely to make the needed behavior changes to improve their quality of life (Kariuki, 2022).
The nurse should use multiple educational strategies to increase client confidence and compliance. Educational strategies may include teach-back evaluation of understanding, programmed medication reminders, access to their medical records, easy communication with their provider, and condition-specific educational resources in multiple formats, including digital formats (Kariuki, 2022). The nurse should educate the client on some of the common difficulties they will face when following the nutritional plan and provide specific strategies to address them. The nurse should provide their client with some tips and tricks to help with some of the previously mentioned difficulties Table 15.3.
| Electrolyte/Restrictions | Substitutions/Hacks |
|---|---|
| Fluids |
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| Potassium |
|
| Sodium |
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| Phosphorus |
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| Magnesium |
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| Fat |
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| Protein |
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| Calcium |
|
To optimize renal health, it is imperative that clients with preexisting kidney disorders seek advanced nutritional counseling. Nurses can meet this need and positively impact client outcomes by obtaining certifications in nutrition science. As nursing roles expand, nurses continue to look for opportunities to positively impact client care. Several strategies can enhance the nurse’s delivery of care, mastery of knowledge, and future job opportunities.
In this Trending Today, explore opportunities that build upon a nursing license as a base to add skillsets to your practice and certifications to your resumé. Evaluate one of the following to determine benefits and challenges of these professional development areas:
- National Academy of Sports Medicine Certified Nutrition Coach at www.nasm.org/
- Cornell Nutrition and Healthy Living Certificate at https://online.cornell.edu
- National Board of Nutrition Support Certification at https://www.nutritioncare.org
Now answer the following questions:
- Which evidence-based practice certification did you view, and why?
- How would obtaining this certification impact the care you provide?
- How would obtaining this certification impact your practice potential?
- As a nurse, how would you use a nutrition certification to help your client achieve their optimal level of health?
Read the following clinical scenario and then answer the questions that follow. This case study will evolve throughout the chapter.
Mr. Vasquez is in the clinic for a routine visit following his education session with the renal dietician 2 weeks prior. The nurse reviews his food recall report for the last 3 days (72 hours) to evaluate the need for further education. The client’s diagnoses include obesity, hypertension, diabetes mellitus type 2, and CKD stage 2, so his nutritional education would have included all these issues.
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Cupcakes
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Fruit salad
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Ice cream
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Chocolate milk