15.5: Evaluate Nutritional Strategies to Impact Renal Wellness
By the end of this section, you should be able to:
- 15.4.1 Evaluate a nutritional plan for its effects on renal wellness.
- 15.4.2 Modify a nutritional plan to promote renal wellness.
Evaluating the Effectiveness of a Nutritional Plan for Renal Wellness
Evaluation of the effectiveness of a nutritional plan involves evaluation of both client adherence to the plan and the effectiveness of the plan to reach the intended outcomes. Mr. Vasquez’s nutritional plan is considered in the following Unfolding Case Study feature. If the plan is ineffective in any way, the nurse should determine the cause—adherence or general ineffectiveness—so that they can make appropriate changes.
Read the following clinical scenario and then answer the questions that follow. This case study is a follow-up to Case Study Part A.
At the last visit, Jose Vasquez was educated on nutritional changes that will help preserve kidney function and manage comorbidities. At a recent physical examination, the following are noted:
| Vital Signs | Physical Examination | |
|---|---|---|
| Temperature: | 97.9°F (36.6°C) |
|
| Blood pressure: | 118/76 mm Hg | |
| Heart rate: | 98 beats/min | |
| Respiratory rate: | 14 breaths/min | |
| Oxygen saturation: | 97% on room air | |
| Weight: | Client has lost 3 lb (5.44 kg) since his last visit 3 months ago | |
| Finger stick glucose level: | 100 mg/dL |
Mr. Vasquez reports following the nutritional guidelines strictly, and his food diary reflects this to be the case. Lastly, the nurse receives the following lab results from the sample drawn 2 days ago as a preparation for this visit:
| Lab Test | Normal Range | Mr. Vasquez’s Lab Results |
|---|---|---|
| GFR | 90–120 mL/min/1.73 m 2 | 52 mL/min/1.73 m 2 |
| Potassium | 3.5–5.0 mEq/L | 6.2 mEq/L |
| Sodium | 135–145 mEq/L | 122 mEq/L |
| Phosphorus | 2.5–4.5 mg/dL | 5.3 mg/dL |
-
Plan is effective.
-
Plan is ineffective due to client nonadherence.
-
Plan is ineffective despite client adherence.
-
Unable to judge plan effectiveness with assessment presented.
-
Increase calcium.
-
Restrict fluids.
-
Restrict magnesium.
-
Increase fats.
Modifying a Nutritional Plan to Promote Renal Wellness
Unfortunately, renal disease may still progress even when the client follows an appropriate nutritional plan; the client’s nutritional plan may need to be modified.
Read the following clinical scenario and then answer the questions that follow. This case study is a follow-up to Case Study Parts A and B.
It is determined that, despite Mr. Vasquez following the nutritional plan, his condition has worsened. Although this disease process will progress regardless, it is still prudent to address the plan because the client’s disease is now in an advanced stage; the plan requires modifications to prevent further injury.
-
Quinoa
-
Skin-on baked chicken
-
Sirloin steak, well-done
-
Fried fish