CCHT Nutrition and Fluid Management 3

Question 1

A dialysis patient complains of severe muscle cramps during the last hour of treatment every session. What dietary or fluid management change might help prevent this complication?

Accepted Answer

Reduce interdialytic weight gain through dietary sodium restriction to allow a lower ultrafiltration rate

Answer

Increase potassium intake to replenish intracellular stores lost during dialysis

Answer

Increase fluid intake between treatments to prevent intravascular dehydration

Answer

Start high-dose vitamin D supplementation to prevent muscle hypocalcemia

Question 2

A patient on dialysis is prescribed a phosphate binder. When should the patient take this medication to achieve maximum effectiveness?

Accepted Answer

With or immediately before each meal and snack

Answer

At bedtime to allow overnight absorption

Answer

First thing in the morning on an empty stomach

Answer

Immediately after dialysis to replace dialysis losses

Question 3

What is the target daily caloric intake recommendation for a hemodialysis patient to maintain weight and prevent catabolism?

Accepted Answer

30–35 kcal/kg/day

Answer

20 kcal/kg/day

Answer

40–45 kcal/kg/day

Answer

50 kcal/kg/day

Question 4

Why is dietary phosphorus restriction challenging for hemodialysis patients who require adequate protein intake?

Accepted Answer

Phosphorus and protein are co-located in many foods, so restricting phosphorus often reduces protein intake below recommended levels

Answer

High-protein foods are uniformly low in phosphorus, so restricting protein resolves both issues simultaneously

Answer

Protein supplements for dialysis patients contain high phosphorus levels that cannot be avoided

Answer

The phosphorus restriction only applies to plant-based protein sources

Question 5

Which of the following is an appropriate fluid intake for a hemodialysis patient who is anuric and has been instructed to limit fluid to 1000 mL/day?

Accepted Answer

2 cups of coffee (480 mL), 1 small bowl of gelatin (120 mL), and 1 glass of water (240 mL)

Answer

2 cups of coffee, 1 bowl of soup, 3 glasses of water, and 1 glass of juice

Answer

Unlimited intake of sugar-free beverages because they have no caloric impact on fluid balance

Answer

1 glass of water per meal (3 glasses = 720 mL) plus unlimited water with medications

Question 6

A hemodialysis patient reports eating the following foods since their last treatment: a banana, tomato soup, a glass of orange juice, and potato chips. Which electrolyte imbalance is most concerning?

Accepted Answer

Hyperkalemia from multiple high-potassium foods consumed simultaneously

Answer

Hypocalcemia from calcium-binding dietary oxalate

Answer

Hyperphosphatemia from phosphorus in tomato soup additives

Answer

Hyponatremia from excessive fluid intake