Nutrition Intervention for Pre-Dialysis Chronic Kidney Disease
James, a 49 year old male, has developed chronic kidney disease as a result of uncontrolled hypertension. James works as a correctional officer and finds his job to be highly stressful. He is aware that he has had hypertension for over 10 years buy has never taken measures to treat it. One year ago, James started experiencing headaches and was tired all the time. He had protein in his urine at that time and was diagnosed with chronic kidney disease. At this most recent visit, James mentions that he has lost weight and is frequently nauseated, and that he bleeds very easily.
James receives a prescription for lisinopril, an ace inhibitor prescribed for the management of hypertension to prevent kidney disease progression. Based on the clinician’s understanding of this medication what effect is most likely to occur with its use?
a. It prevents calcium reabsorption.
b. It reduces proteinuria
c. It promotes glucagon synthesis
d. It increases blood glucose levels.
e. It blocks the uptake of sodium in the cells.
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James has been losing weight since his last visit with the healthcare provider. He is weighed in the office and his current weight is 158lbs. James energy needs based on his weight and age would be?
a. 2306 kcal
b. 2506 kcal
c. 2772 kcal
d. 2813 kcal
e. 2990 kcal
James is working to put on some weight again and to try and return to his former weight. He has started to eat foods high in fat and kcalories in hopes of gaining weight. James is at increased risk of heart disease because of his high blood pressures; if he continues to eat fatty foods that are high in kcalories, he may further increase his risk, yet he needs to gain weight. What type of food should be recommended to James that will help him with weight gain but that would be less likely to contribute to heart disease?
a. chicken with pesto sauce
b. a hamburger with lettuce and tomato
c. an omelet with cheese, onions, and green peppers
d. a dark chocolate candy bar
e. spinach and artichoke dip with pita crackers.
James has a follow a follow-exam to test his weight and blood pressure and has laboratory testing to check his electrolyte levels. His results are as follows:
Sodium: 136 mEq/L
Potassium: 4.0 mEq/L
Chloride: 101 mEq/L
Calcium: 8.4 mEq/L
Albumin: 3.4 mEq/L
Based on his laboratory results how much calcium should James be counseled to take in each day?
a. 600 mg
B. 1200 mg
c. 1600 mg
d. 1800 mg
e. 220 mg