Mrs. Kouassi is a 44-year-old African from the Ivory Coast. Although she was dia

Question

Mrs. Kouassi is a 44-year-old African from the Ivory Coast. Although she was diagnosed with hypertension about eleven years ago, it was left untreated. A year ago, she was seen in the Emergency Department for fatigue, poor appetite, nausea, and vomiting. She complained of shortness of breath, muscle weakness, and swelling of her lower legs. Her blood pressure reached 220/210. She was hospitalized, diagnosed with end-stage renal disease (ESRD), and started on hemodialysis. She currently goes to a dialysis center four times a week. She has not been working since receiving disability. Currently, her parathyroid hormone is elevated she was diagnosed, and is Mrs. Koua lis 5 feet 5 inches tall and weighs 145 pounds. When asked about her diet, Mrs. Kouassi states that she tried to follow the prescribed diet, but it is difficult because she likes to eat African foods such as palm oil and butter, rice, yams, soups, tea, and dishes such as bufu (cooked fine-blended cassava) She also likes fruits and vegetables, especially when they are combined with other foods such as in 1. What diseases or conditions can lead to chronic kidney disease? 2. What signs and symptoms of chronic kidney disease did Mrs. Kouassi exhibit when originally 3. What dietary recommendations are appropriate for Mrs. Kouassi in terms of energy, protein, fat, fluids, sodium, potassium, calcium, and phosphorus? Refer to Table 22-5 for assistance. 4. How does hemodialysis help to prevent disease progression? 5. Why are protein restrictions relaxed once dialysis begins? 6. What would be the best strategy for collecting data to use in teaching Mrs. Kouassi how to incorporate her ethnic foods into an appropriate diet plan?

Explanation / Answer

1.Any condition or disease that damages blood vessels or other structures in the kidneys can lead to kidney disease.High blood sugar levels caused by diabetes damage blood vessels in the kidneys. If the blood sugar level remains high over many years, this damage gradually reduces the function of the kidneys .Uncontrolled high blood pressure damages blood vessels, which can lead to damage in the kidneys. And blood pressure often rises with chronic kidney disease, so high blood pressure may further damage kidney function. Having a narrowed or blocked renal artery. A renal artery carries blood to the kidneys. Long-term use of medicines that can damage the kidneys. Examples include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, and certain antibiotics. 2. Because she was suffering from chronic kidney disease,the symptoms that she showcased was poor appetite,nausea,vomiting,muscle weakness,swollen legs,breathlessness which are all common symptoms of this disease. Generally at an early stage there are no such symptoms but after a blood test if the condition persists then at a later stage these symptoms appear. 3. A proper diet plan needs to be followed as recommended by the doctor depending upon the condition and the body. If the doctor has recommended a low-protein diet, then the individua; may replace the calories from protein with:Fruits, breads, grains, and vegetables. These foods provide energy, as well as fiber, minerals, and vitamins. If needed, one can even eat high-calorie desserts such as pies, cakes, or cookies, as long as one limits desserts made with dairy, chocolate, nuts, or bananas. In fats,it needs to be unsaturated fat like using olive oil,sunflower oil etc. Initially because of dialysis,a low protein diet is needed, and then at a later stage eggs,fish,chicken etc. can be included. Limit the amount of dairy foods one eats, because they contain large amounts of phosphorous. This includes milk, yogurt, and cheese. Reducing sodium intake is also important as it would control high blood pressure. 4.Hemodialysis is a treatment to filter wastes and water from your blood, as your kidneys did when they were healthy. Hemodialysis helps control blood pressure and balance important minerals, such as potassium, sodium, and calcium, in your blood. During hemodialysis, your blood goes through a filter, called a dialyzer, outside your body. A dialyzer is sometimes called an “artificial kidney.”The dialysis machine pumps blood through the filter and returns the blood to your body.Waste products from your blood move into the dialysis solution. Filtered blood remains in the hollow fibers and returns to your body. There is no effective treatment for kidney disease,a complete cure is not present so dialysis is the only way to slow down the progression of the disease. Following a healthy diet is also important as well.

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