Sharon M. Boyd, MS,MA, RD
Renal Nutrition Specialist
University of Michigan Health Service
Author

Ninfa Saturnino Springer, PhD, RetRD, FADA
Professor Emeritus
University of Michigan
Author

Robert E. Springer, MFA
Editor & Web Design

 

 ACKNOWLEDGEMENTS 

The authors gratefully acknowledge the expert assistance of the reviewers: Mary Hodge, M.S., R.D., Nutrition Specialist, University of Michigan Health Systems, Michelle Kruger, R.D., Botsford Hospital, Farmington Hills, MI and Jan Lee, Ph.D., R.N., Associate Professor and Director, Undergraduate and Non-Traditional Programs, School of Nursing, University of Michigan, Ann Arbor, MI. The authors also thank Candace Boyd for preparation of the manuscript, and Robert E. Springer, Jr. for his editorial review and unwavering support.

 

 

UNIT GOAL AND OBJECTIVES

This unit focuses on End Stage Renal Disease (ESRD) and uses Erica as the case simulation. It follows the deterioration of her kidney functions as it progresses from initial assessment and diagnosis through dialysis and transplant. As medical treatment changes, nursing/nutrition interventions likewise are modified.

The goals of this unit is to screen/assess for nutrition and eating problems, and to integrate laboratory findings to suggested modifications of diet and eating habits to improve nutritional status.

 After using this unit, you will be able to -
- Identify abnormal blood serum values
- Screen and identify nutrition and eating problems
- Determine adverse dietary habits
- Examine how diet is modified for each stage of ESRD integrating laboratory and nutrition screening/assessment findings:
Predialysis
Continuous ambulatory peritoneal dialysis (CAPD)
Hemodialysis
Transplant
- Suggest food substitutions to meet prescribed diet plan
- Give accurate nutrition and diet information specific to ESRD		  

 

GUIDE AND DIRECTIONS

Before beginning this unit, it is highly recommended that you read some of the references included in the section on Suggested Readings and review a textbook on renal physiology and pathophysiology of ESRD. The Glossary and Suggested Readings may also help you when you come to terms or concepts that are unfamiliar to you. You are encouraged to use such resources as MedSearch and other online sources specific to ESRD. You might also review the biochemistry and functions of nutrients particularly those critical in ESRD. A summary of these significant nutrients in ESRD and food sources for phosphorus, potassium, protein, and sodium are given under the section, Unit Background.

You are now ready to read the Client Overview and Client Records. Erica's case is a lengthy, multi-stage simulation. You will select one of the sub-units of the assessment and intervention pathways labeled CAPD, Hemodialysis and Transplant, depending on your interest and/or assignment. Each of these combinations begins with Initial Assessment and Predialysis Nutrition Therapy. When appropriate, check and confirm your selection with your instructor.


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 Copyright 2003, 2000 by N. S. Springer

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