Nutritional Case Study: Chronic Renal Failure

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Nutritional Case Study: Chronic Renal Failure Ian, age 28, in the last few months the client has developed end-stage renal disease related to glomerulonephritis. The clients kidneys are not producing enough urine and at times do not produce any urine, which requires the patient to receive hemodialysis three times per week. The client would like to receive a kidney transplant but understands that the wait list is very long. Upon physical examination the client’s skin appears ashen in color, pale conjunctivae, and has an overall wasted appearance. The client’s blood pressure is 162/105, pulse 92 and reparations are 20. The lab values found low hemoglobin and hematocrit along with a high BUN and creatine levels. From the last hemodialysis, two days ago, patient has gained six pounds and has edema of the ankles, with crackles auscultated in both lungs. The patient has claimed, “I’m sick of trying to follow the diet the dietitian recommended. It’s not worth it.” Client has stated, “I know what I am supposed to eat, but it’s too hard. I just eat and drink what I like whenever I want to”. Client has stated, “I don’t have any energy. I’m tired all of the time.” Client has expressed, “Food doesn’t taste good anymore. I don’t have any appetite.” Client has also expressed, “Why try? Dialysis will take care of any extra fluid and minerals.” The first nursing diagnosis that can be applied is imbalanced nutrition: less than body requirements related to anorexia, fatigue, and altered taste secondary to impaired renal function evidenced by ashen skin, pale conjunctivae, wasted appearance, high BUN, and low hemoglobin and hematocrit can be given. Based on this nursing diagnosis the client will start to make a plan to help change his views of nutrients and their importance on the body. To influence the client to work on improving this nursing diagnosis the plan needs

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