Author Question: Mrs. Joaquin has a PO4 restriction. Why? What foods have the highest levels of phosphorus? What ... (Read 9 times)

plus1 · **on:** Aug 21, 2018

Mrs. Joaquin has a PO4 restriction. Why? What foods have the highest levels of phosphorus?

What will be an ideal response?

Question 2

On post-op day one, Mr. McKinley was advanced to the Stage 1 Bariatric Surgery Diet. This consists of sugar-free clear liquids, broth, and sugar-free Jell-O. Why are sugar-free foods used?

What will be an ideal response?

wshriver · **Reply #1 on:** Aug 21, 2018

Answer to Question 1

Most Stage 5 CKD patients have elevated serum PO4 d/t lack of activated vitamin D.
If P stays elevated it stimulates PTH release to promote P excretion, but instead increases breakdown of bone and release of calcium, leading to several bone disorders. The kidney's lack of responsiveness to PTH's signal (from its damage) causes this osteodystrophy due to the overstimulation of PTH secretion.
To help control blood levels of PO4, it is restricted in the diet and patients often take binders as well to decrease absorption.
Dairy products and beverages
Dried beans and peas
Organ meats
Whole grains
Nuts
Dark colas
Chocolate

Answer to Question 2

Sugar-free foods are used to prevent dumping syndrome.
Dumping syndrome is characterized by nausea, vomiting, bloating, and diarrhea and is caused by hyperosmolar foods, which are usually simple carbohydrates.
The hyperosmolar foods cause water to be pulled into the intestine. This occurs because part of the intestine is bypassed and the pyloric sphincter is removed in the roux-en-Y procedure, which gives less surface area and transit time for absorption.
In order to prevent dumping syndrome, the AND Nutrition Care Manual recommends avoiding simple carbohydrates such as fruit juices or other foods high in sugar.