If BT was following his diet and medication plans as prescribed, ...

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If BT was following his diet and medication plans as prescribed, the dietitian was making her determinations based on his anthropometric measurements and lab values. Using these two parameters, give possible explanations for the changes the dietitian recommended in BT's nutrition care plan.

Question 2

Usually the amounts of dietary protein, Na, K, and fluids allowed on CAPD are more than what are allowed for HD and PD. The kcal allotment for CAPD is usually lower than HD and PD. Explain why this is so.

[harveenkau8139]

Answer to Question 1

Kcals: She reduced BT's kcals because he gained weight, 5 kg over his usual weight.

Protein: She increased his protein slightly. This was probably done to enable him to eat more meat. The fact that he is active and that he will lose more amino acids through CAPD will make this possible.

Na: His Na was increased because it was low and CAPD provides a greater chance for a loss of Na.

Ca: Calcium was increased because it was on the low side of normal and Ca balance in renal patients is very important.

Answer to Question 2

Since the dialysate stays in the peritoneal cavity all day, there is a constant absorption of amino acids, Na, K, and fluids. After a meal, when the blood concentration of these nutrients goes up, they are also constantly being defused across the peritoneal cavity. As a result of this, a larger amount of these nutrients can be ingested. However, as calculated in question 4, a significant amount of glucose is absorbed from the dialysate in the other direction, accounting for a significant amount of calories. Because of this fact, the caloric content (particularly sugar) of the diet has to be restricted or an increase in weight will occur.