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Case Study: CB

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catherine arendt

on 18 January 2013

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Transcript of Case Study: CB

Catherine Arendt Case Study: CB 68 y/o, African American, female

Pt is very independent. Good energy level.

Shops & prepares own meals.

Retired.

Daughter currently lives with pt. Demographics: CB Ht:5'5", 66"
EDW:220#, 100kg
UBW: 200#, 91kg
BMI: 35.5 (Obese)
Standard Body Wt: 145#, 66kg
Adjusted Body Wt: 202#, 92kg Anthropometrics: CB Current Dx: ENRD, Renal Secondary Hyperparathyroidism, HTN, Anemia of CKD

PMH: CAD, Hyperlipidemia, Peripheral Vascular Disease, and headache.

Diet Hx:High PRO, High potassium, Low phosperous, no fluid restriction. Medical and Diet History Calcitriol 0.75mcg oral capsule
0.25mcg, 3 times daily
Carvedilol 50mg
2 times a day
Crestor 5mg oral tablet
1 orally once a day
Dialyvite 800
1 orally once a day
Ferrimin 150
1 orally once a day
Lasix 20mg oral tablet
1 orally every other day
Norvasc 5mg oral tablet
1 orally once a day
Plavix 75mg oral tablet
1 orally once a day
Senna
2 orally once a day
Sensipar 30mg oral tablet
1 orally Monday, Wednesday, and Friday
Sorbitol 70% oral liquid
1 orally once a day Medications Nutrition Assessment Current Treatment CCPD, CAPD care supervision
% Dextrose: 2.5 exchanges
Calcium Bath: 2.5Meq
Total Sleep Time: 7hr 50 minutes
24 hr Total Fluid Volume: 8 Liters Cycle 5 fills Volumes Times 1 pause - Fill Volume:
2000 Pause Volume:
1000 Last Fill Volume:
1000 Dwell Time:
1hr 30min Fill Time:
20min Drain Time:
20min Estimated Kcals of PD Treatment CCPD CAPD 3 Fills = 6000ml 34-43 kcal/Liter 204-258 kcals 1 Fill + 1 pause = 2000ml 51- 60 kcal/Liter 102-120 kcals 306-378 kcals/day Do Differently Next Time? 1. Educate pt about the importance of protein in her diet.
2. Encourage pt to eat at least 3 meals a day that include a protein source.
3. Provide addition sources of protein. Questions? References
Flanigan, M., Lim, V., & Redlin, J. (1995). The significance of protein intake and catabolism. . Advances in renal replacement therapy, 2(4), 330-340. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8591124

The National Kidney Foundation. (2013). Nutrition and peritoneal dialysis. Retrieved from http://www.kidney.org/atoz/content/nutripd.cfm

Tzamaloukas, A., Dimitriadis, A., Murata, G., Nicolopoulou, N., Malhotra, D., Balaskas , E., Kakavas , J., & Antoniou , S. (1996). Continuous peritoneal dialysis in heavyweight individuals: urea and creatinine clearances. . Journal of the international society for peritoneal dialysis, 16(3), 302-306. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8761545

Wilkens, K., & Juneja, V. (2008). Medical nutrition therapy for renal disorders. In K. Mahan & S. Escott-Stump (Eds.), Krause's food & nutrition therapy (12 ed., pp. 921-990). St. Louis: Saunders, Elsevier.
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