Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
WITH HEMODIALYSIS
Danielle Vivarttas-Ahrnsbrak & Rosae Calvo
FSHN468: Case Study
02-20-2014
PT HISTORY
22YOM Malaysian
college student
PMHx:
Mild
HF (chest x-ray)
HTN
CAPD
x 3-mon
HPI:
CAPD
non-compliance
N/V
HF
ASSESSMENT
Anthro
On
admissionN/V, HF
During admission
frequent PDHD 3x/wk,
urine output<200ml/24
hrs
Ht
69 Wt 170-lb
106%IBW 110%UBW 15-lb
gain in 6 mon, BMI 25.1
kg/m2
Biochemical
Lytes,
Ca WNL
CO2 22mEq/L (Low)
Phos 8.4 mg/dL (High)
Alb 3.5 g/dL (Lownormal)
Hgb 9.3 g/dL, Hct 28%,
Ferritin 185 ng/dL (Low)
Clinical
Diet
Refined
CHO, Tea/Soda,
salty/sweet snacks
2493 kcal 110g pro (18%)
98g fat (35%) 303g CHO
(48%)
3.8g K, 1.6g Na, 1.2g
Phos, 14mg Fe
Fluid intake = 1680mL
ESTIMATION OF NEEDS
Energy
2460
Protein
93g
87g
~90g
(1.2 g/kg)
Fluid
950mL/d
NUTRITION PLAN
Dx
NI
INTERVENTION
Pt. Education:
Lower
PO4 binders
Recommend H20-soluble multi-renal vitamin w/ 1
mg/d folate, possibly Vit. E
Refer to HD RD to monitor labs
MONITORING
EVALUATION
RESEARCH ARTICLES
Changes in
Anthropometry and
Mortality in
Maintenance
Hemodialysis
Patients in the HEMO
Study
http://www.ncbi.nlm.nih.gov.eres
.library.manoa.hawaii.edu/pubme
d/?
term=Changes+in+Anthropometry+
and+Mortality+in+Maintenance+He
modialysis+Patients+in+the+HEMO
+Study
Nervous system
autoantibodies and
vitamin D receptor
gene
polymorphisms in
hemodialysis
patients
http://www.ncbi.nlm.nih.gov
/pmc/articles/PMC3919036/