Nutrition and Fluid Management Flashcards
7 cards from real CCHT practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Nutrition and Fluid Management flashcards as text
A patient on hemodialysis is prescribed a phosphate binder. When is the most effective time for the patient to take this medication?
Answer: With meals
Phosphate binders work by binding to phosphorus in food while it is in the gastrointestinal tract, preventing its absorption into the bloodstream. Taking them with meals ensures they are present when the dietary phosphorus is ingested, maximizing their effectiveness.
Which of the following foods is highest in potassium and should be limited by most hemodialysis patients?
Answer: Potatoes
Potatoes, especially when cooked with the skin, are very high in potassium. Hemodialysis patients often have difficulty excreting potassium, which can lead to dangerous hyperkalemia, so high-potassium foods are typically restricted.
What is generally considered a safe interdialytic weight gain (IDWG) for a hemodialysis patient?
Answer: Less than 5% of dry weight
A safe IDWG is typically considered to be less than 5% of the patient's estimated dry weight (EDW). Gaining more than this amount between treatments can lead to complications like hypertension, pulmonary edema, and increased cardiovascular strain.
The primary reason for restricting sodium intake for patients on hemodialysis is to:
Answer: Control thirst and fluid intake.
Sodium intake is a primary driver of thirst. By restricting sodium, patients can better manage their thirst, which in turn helps control their fluid intake and limit interdialytic weight gain, reducing the risk of fluid overload.
Compared to the general population, the protein needs of a patient on maintenance hemodialysis are typically:
Answer: Higher.
Patients on hemodialysis have higher protein requirements because some amino acids and proteins are lost during the dialysis process. A high-protein diet is essential to maintain muscle mass and overall nutritional status.
A low serum albumin level in a hemodialysis patient is a strong indicator of:
Answer: Malnutrition and inflammation.
Albumin is a protein made by the liver, and low levels (hypoalbuminemia) are a key marker of protein-energy wasting (malnutrition) and inflammation in dialysis patients. It is associated with increased morbidity and mortality.
A patient's daily fluid allowance is often calculated based on their previous day's urine output plus a standard amount for insensible losses. What is this standard additional amount?
Answer: 500-1000 mL
For patients who still produce urine, a common method for calculating the daily fluid allowance is to measure the 24-hour urine output and add 500 to 1000 mL. This additional amount accounts for insensible losses from breathing and sweating.