Questions and Answers
What is the function of the kidneys?
They remove waste products and regulate blood pressure
What does NFPA evaluate to determine malnutrition or risk of malnutrition?
All of the above
What is the functional unit of the kidney responsible for filtering the blood?
Nephrons
Which of the following is NOT a part of the NFPA assessment?
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What is acute renal failure (ARF)?
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Who conducts the NFPA assessment?
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What is chronic kidney disease (CKD)?
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Can nutrition deficiencies be identified using NFPA findings alone?
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How can basic NFPA be utilized as a screening tool?
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What can cause CKD?
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How is CKD classified?
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What should be done when performing NFPA?
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What is the purpose of NFPA?
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What can patients with CKD experience as the disease progresses?
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What is end-stage renal disease (ESRD)?
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What does NFPA measure?
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What is the goal of nutrition therapy for CKD?
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Who should abnormal findings be relayed to during NFPA?
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What type of diet is typically prescribed for patients with CKD?
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Is NFPA the only approach used to identify nutritional deficiencies?
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What does NFPA focus on?
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Why is protein intake limited for patients with CKD?
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What is the purpose of NFPA as a screening tool?
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Why is fluid restriction necessary for patients with CKD?
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Study Notes
- The kidneys are bean-shaped organs located below the rib cage.
- They remove waste products, maintain electrolyte levels, and regulate blood pressure.
- The kidneys filter about 120-150 quarts of blood to produce 1-2 quarts of urine per day.
- Nephrons are the functional units of the kidney responsible for filtering the blood.
- Acute renal failure (ARF) is a rapid decline in kidney function that can result in nutritional imbalances.
- Chronic kidney disease (CKD) is a progressive loss of kidney function that can lead to renal failure.
- CKD can be caused by diabetes, high blood pressure, heart disease, cancer, autoimmune diseases, certain medications, or alcohol/drug abuse.
- Early kidney disease usually has no symptoms, so testing is necessary to detect CKD.
- Nutrition-focused physical assessment (NFPA) is important in identifying and diagnosing malnutrition.
- NFPA includes measurement of vital signs, body composition, inspection for nutrient deficiency, auscultation of heart/lung sounds, inspection of the abdomen, dermatologic assessment, head, neck and oral cavity exam, and cranial nerve examination.
- Chronic kidney disease (CKD) is a condition in which kidneys gradually lose their function over time.
- CKD can be detected through urine tests that measure the presence of albumin.
- CKD is classified into 5 stages based on the glomerular filtration rate (GFR).
- As CKD progresses, patients may experience malnutrition, fluid and electrolyte imbalances, mineral and bone disorders, anemia, and uremia.
- End-stage renal disease (ESRD) is the final stage of CKD and requires dialysis or a kidney transplant.
- Nutrition therapy for CKD aims to slow the progression of the disease, manage blood pressure and blood sugar, improve nutritional status, and delay the need for dialysis.
- Patients with CKD are typically prescribed a low-sodium, moderate-protein diet.
- Protein intake should be limited to reduce stress on the kidneys and decrease the risk of hyperphosphatemia.
- Patients should choose heart-healthy fats and limit refined and processed foods high in sugar and sodium.
- Restrictions on potassium and phosphorus intake may be necessary in later stages of CKD.
- Fluid restriction is determined by medical status, blood pressure control, physical findings, and urine output.
- Fluids include not only drinks but also foods that are liquid at room temperature or have high water content.
- Examples of fluids to be limited include soup, ice cream, nutritional supplements, watermelon, gelatin, and ice cubes.
- Fluid restrictions are annotated in milliliter requirements and vary between 1,000-2,000 ml/day.
- The amount of fluid a person is allotted per meal depends on their restriction level and the amount needed for teeth brushing or medications.
- Dietary fluids are often limited to 8-10 oz per meal and 4 oz with a snack.
- Patients on restricted fluids may be thirsty but should not request extra drinks or fluids.
- Fluid restrictions are important for medical reasons and should be followed as ordered.
- Ignoring fluid restrictions can lead to complications and worsen medical conditions.
- Patients should consult with their healthcare provider if they have questions or concerns about their fluid restrictions.
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