Answer to Question 1
Nutrition counseling should include goal-setting, self-monitoring, stimulus control, problem-solving, contingency management, cognitive restricting, use of incentives and rewards, and social supports
MNT should last at least 3 months or until initial weight-management goals are achieved
Weight control is often a life-long condition and it is critical that a weight management plan be implemented after the intensive phase of treatment
More contact between the patient and RD may lead to more successful weight loss and maintenance
Answer to Question 2
The general course of progress kidney failure is now divided into five stages.
Stage Description GFR (mL/min/1.73 m2)
-- At increased risk 60 (with CKD risk factors)
1 Kidney damage with normal or increased GFR 90
2 Kidney damage with mild decrease in GFR 60-89
3 Moderate decrease in GFR 30-59
4 Severe decrease in GFR 15-29
5 Kidney failure <15 (or dialysis)
CKD is defined as either kidney damage or GFR <60 ml> Kidney damage is defined as pathologic abnormalities or markers of damage, including abnormalities in blood or urine tests or imaging studies.
Signs, symptoms, and laboratory abnormalities distinguish disease pathophysiology.
Elevated BUN and creatinine
Nocturia
Lassitude
Fatigue
Decreased mental acuity
Neuromuscular: coarse muscular twitches, peripheral neuropathies with sensory and motor phenomena, muscle cramps, and convulsions
Anorexia, nausea, vomiting
Stomatitis
Unpleasant taste in mouth
Malnutrition leading to generalized wasting
Hypertension
Cardiomyopathy
Possibly congestive heart failure or dependent edema (renal retention of Na and water)
Yellow-brown cast to skin
Pruritus
Renal osteodystrophy
Osteomalacia
Abnormal lipid metabolism (hypertriglyceridemi a)
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