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Nutrition: Exam #5: Renal & GI (Chapters
23-25, Highlight 24) Exam Questions And
Answers 100% Pass
What are the functional units of the kidneys called? - answer✔nephrons
The kidneys activate which vitamin? - answer✔Vitamin D
What hormone secreted by the kidneys stimulates the production of red blood cells? -
answer✔erythropoietin
The consequences of nephrotic syndrome include? - answer✔- Edema
- blood lipid & blood clotting abnormalities
- depletion of immunoglobulins (increases susceptibility to infection
- loss of Vitamin D binding protein (results in lower Vit. D & calcium levels, increasing risk of rickets in
children)
- protein energy malnutrition (PEM)
- muscle wasting may develop
Daniel is a 10-year-old boy that has just been diagnosed with nephrotic syndrome. He is at increased risk
of the bone disease _____. - answer✔Rickets
Nutrition therapy, as a treatment for nephrotic syndrome, focuses on___, ___, and ___. -
answer✔Prevent PEM, alleviate edema, & correct lipid abnormalities
For patients with nephrotic syndrome, the recommended daily protein intake is __ to __/kg body weight
- answer✔0.8-1.0 g/kg of body weight/day
Oliguria is the term to describe diminished urine output, often less than ___ mL/day. - answer✔400
mL/day
What ranges of protein intake are recommended for a patient with limited kidney function who is not
treated with dialysis? For patients on HD or PD? This requires that you know your stages of chronic
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kidney disease - answer✔Limited Kidney Function Not Treated with Dialysis: 0.8-1.0 g/kg of body
weight/day
HD/PD: 1.0-1.7 g/kg/day
Uremia develops during the final stages of CKD when GFR is below _____ milliliters per minute and
blood urea nitrogen exceeds _____ milligrams per deciliter. - answer✔GFR <15 mL/minute
BUN: >60 mg/dL
Uremic syndrome clinical effects include? Be able to understand and describe these. - answer✔- altered
mental status
- neuromuscular changes: muscle cramping, twitching
- impaired hormone synthesis: erythropoietin - anemia; reduced production of vitamin D → bone
disease
- bleeding abnormalities: defects in platelet function & clotting factors along w/ skin changes
- cardiovascular disease risk: HTN, ↑ insulin resistance, & abnormal blood lipids
- ↓ immunity - poor immune response - prone to infection, a frequent cause of death
True or False: The patient with CKD will often present with anemia, diabetes, PEM, metabolic
stress/infection which will alter nutritional status. - answer✔True
Patients should be advised that which of the following foods contribute to the fluid allowance in fluid-
restricted diets?
a. Gelatin/Jello
b. Popsicles
c. Sherbet
d. Fruit ice
e. Ice cream - answer✔all of them, because they all melt & turn into liquid
Gelatin/Jello; Popsicles; Sherbet; Fruit ice; ice cream
Name several ways the health practitioner can assess fluid status in the patient with kidney disease -
answer✔Monitoring weight fluctuations, blood pressure, pulse rates, & appearance of the skin &
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mucous membranes. Additionally, looking at the serum sodium lab: low sodium = excessive fluid intake
// high sodium = inadequate fluid intake
Once a person is on dialysis, sodium and fluid intakes should be controlled so that only about ____ lbs of
water weight are gained daily. - answer✔2.2 lbs
Intakes of supplemental vitamin C are restricted in patients with chronic renal failure to prevent? -
answer✔risk for kidney stones
A factor that predisposes people to kidney stone formation is? - answer✔- dehydration
- low urine volume
- changes in urine acidity
- metabolic abnormalities
- obstruction
- renal disease
What foods/practices contribute to high uric acid levels? - answer✔- animal protein
- inadequate water intake
- alcoholism
- high fructose corn syrup (HFCS)
- crash diets
- shellfish
- organ meats (liver)
- soft drinks
To regulate blood pressure, the kidneys secrete what? - answer✔renin
Where does the majority of sodium come from in a typical diet? - answer✔processed foods
Describe the events leading to the development of bone disease in patients with CKD - answer✔LOSS OF
FUNCTIONAL KIDNEY TISSUE → decreased activation of vitamin D & decreased phosphate ion excretion
→ decreased calcium absorption from intestines & increased serum phosphate→ DECREASED SERUM
CALCIUM → stimulates parathyroid hormone secretion → increased calcium resorption from bone →
increased serum calcium & phosphate deposits in tissue & BONE DEMINERALIZATION → decreased bone
mass, spontaneous fractures, & renal rickets in a child