Client will make 2 specific goals to decrease her potassium intake. Client will make 1 specific goal to decrease her fluid retention.

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Barnard Butler
5 years ago
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1 Title: Renal Diet Target Audience: Renal Dialysis Patients LESSON PLAN Name: Heidi Washburn Terminal Objective Client will be able to plan an appropriate renal dialysis diet for him/herself. Domain Cognitive Taxonomic Level Application References Krause pg 927, Preparation: Flip chart Pre-assessment Lab values: Potassium: 6.0mEq/L (we want meq/l) Gained 10 pounds of water weight. Time (if in class): Terminal Concept Renal patients must follow certain diet restrictions including low protein, low potassium low sodium, and low water in order to prolong health. Introduction Welcome, it is good to see you again. Time: Supporting Objectives Content Outline Time Learning Experiences Client will make 2 specific goals to decrease her potassium intake. What happens in your body when your lab values of potassium: weakness, numbness and tingling if your potassium is at a high level. If your potassium becomes too high, it can cause an irregular heartbeat or a heart attack. Pictures of foods with potassium with amounts including fruits, vegetables, substitute salts, etc. (2-3 g/day) How to leach high potassium vegetables and other helpful hints 4 min Ask: How have you changed your diet to decrease potassium? Ask: What things can you think of that would have caused your potassium levels to be too high? Ask: How can you adjust your diet so that you can meet the requirements for potassium? Client will make 1 specific goal to decrease her fluid retention. Water is important to the body. However, when the kidneys don t function, the water retention can be a big problem. It gets stuck in the interstitial fluid. Sodium increases fluid retention. Ask: What do you remember about what we talked about water last time? Ask: How have these changes gone? Ask: How do you plan to decrease your fluid retention?

2 Client will be able to explain how sodium affects fluid retention. Calculate how much fluid she can have. Pictures of water, milk, other fluids, salt shaker and fruits/vegetables. Hints on how to decrease fluid retention (including sodium). Closure On a scale of 1 to 10, how important is it for you to decrease your potassium intake? How determined are you to do it? On a scale of 1 to 10, how important is it for you to decrease your fluid retention? How willing are you? Why and not?

3 Dialysis Diet

Potassium Potassium keeps your heart beat regular and your muscles working right. Your kidneys keep potassium at just the right level so that these organs work well.

4 Potassium Potassium keeps your heart beat regular and your muscles working right. Your kidneys keep potassium at just the right level so that these organs work well. If your blood potassium becomes too low, you will experience weakness, numbness and tingling. If your blood potassium becomes too high, you are at risk for irregular heart beats and heart attacks.

5 High potassium fruits Apricot, raw (2 medium) dried (5 halves) Avocado (¼ whole) Banana (½ whole) Cantaloupe Dates (5 whole) Dried fruits Figs, dried Grapefruit Juice Honeydew Kiwi (1 medium) Mango(1 medium) Nectarine(1 medium) Orange(1 medium) Orange Juice Papaya (½ whole) Pomegranate (1 whole) Pomegranate Juice Prunes Prune Juice Raisins

6 Low potassium fruits Apple (1 medium) Apple Juice Applesauce Apricots, canned in juice Blackberries Blueberries Cherries Cranberries Fruit Cocktail Grapes Grape Juice Grapefruit (½) Mandarin Oranges Peaches, fresh (1 small) canned (½ cup) Pears, fresh (1 small) canned (½ cup) Pineapple Pineapple Juice Plums (1 whole) Raspberries Strawberries Tangerine (1 whole) Watermelon (limit to 1 cup)

High potassium vegetables Acorn Squash Artichoke

Beans Beets, fresh then boiled Black Beans Broccoli,

Dried Beans and Peas Greens, except Kale Hubbard

Okra Parsnips Potatoes, white and sweet Pumpkin

7 High potassium vegetables Acorn Squash Artichoke Bamboo Shoots Baked Beans Butternut Squash Refried Beans Beets, fresh then boiled Black Beans Broccoli, cooked Brussels Sprouts Chinese Cabbage Carrots, raw Dried Beans and Peas Greens, except Kale Hubbard Squash Kohlrabi Lentils Legumes Mushrooms, canned Okra Parsnips Potatoes, white and sweet Pumpkin Rutabagas Spinach, cooked Tomatoes/Tomato products Vegetable Juices

8 Low potassium vegetables Alfalfa sprouts Asparagus (6 spears) Beans, green or wax Cabbage, green and red Carrots, cooked Cauliflower Celery (1 stalk) Corn, fresh (½ ear) frozen (½ cup) Cucumber Eggplant Kale Lettuce Mixed Vegetables Mushrooms, fresh Onions Parsley Peas, green Peppers Radish Rhubarb Water Chestnuts, canned Watercress Yellow Squash Zucchini Squash

9 Other Foods High potassium Bran/Bran products Chocolate (1.5-2 ounces) Granola Milk, all types (1 cup) Molasses (1 Tablespoon) Nutritional Supplements: Use only under the direction of your doctor or dietitian. Nuts and Seeds (1 ounce) Peanut Butter (2 tbs.) Salt Substitutes/Lite Salt Salt Free Broth Yogurt Low potassium Rice Noodles Pasta Bread and bread products: (Not Whole Grains) Cake: angel, yellow Coffee: limit to 8 ounces Pies without chocolate or high potassium fruit Cookies without nuts or chocolate Tea: limit to 16 ounces

How to decrease potassium For Potatoes, Sweet Potatoes, Carrots, Beets, and Rutabagas: 1. Peel and place the vegetable in cold water so they won t darken. 2. Slice vegetable 1/8 inch thick. 3.

10 How to decrease potassium For Potatoes, Sweet Potatoes, Carrots, Beets, and Rutabagas: 1. Peel and place the vegetable in cold water so they won t darken. 2. Slice vegetable 1/8 inch thick. 3. Rinse in warm water for a few seconds. 4. Soak for a minimum of two hours in warm water. Use ten times the amount of water to the amount of vegetables. If soaking longer, change the water every four hours. 5. Rinse under warm water again for a few seconds. 6. Cook vegetable with five times the amount of water to the amount of vegetable. For Squash, Mushrooms, Cauliflower, and Frozen Greens: 1.Allow frozen vegetable to thaw to room temperature and drain. 2. Rinse fresh or frozen vegetables in warm water for a few seconds. 3. Soak for a minimum of two hours in warm water. Use ten times the amount of water to the amount of vegetables. If soaking longer, change the water every four hours. 4. Rinse under warm water again for a few seconds. 5. Cook the usual way, but with five times the amount of water to the amount of vegetable.

For dialysis patients, the goal is to have: 1500 ml of water + output

11 Water Water is essential to body functions. However, without kidneys, your body cannot get rid of extra water. For dialysis patients, the goal is to have: 1500 ml of water + output each day Drinks, soups, high water fruits/vegetables need to be counted as well ml = 6.34 cups

12 Sodium s effect on body fluids Sodium causes the body to retain water. This causes your blood pressure to rise. It also makes you uncomfortable. To keep your water weight gain down, you may need to limit your sodium intake to 2-3 g/day. To give food taste, try other spices such as basil, curry, dill, ginger, thyme, sage, or rosemary.

Potassium and Your CKD Diet

A TO Z HEALTH GUIDE Potassium and Your CKD Diet What is potassium and why is it important to you? Potassium is a mineral found in many of the foods you eat. It plays a role in keeping your heartbeat regular