11. Nutrition Management Cheat Sheet PDF

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Nutrition management cheat sheet ...

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Chronic Kidney Disease Diet Hx: energy, PRO, Na, K+, P04, Ca, fluid, fibre Fluid overload Stage 3 Management of co-morbidities  Energy: 100-125kJ/kg/day  PRO: 0.75-1g/kg/day  Daily fluid of 2-2.5L  Reduce K+ is hyperkalemic Stage 4 1. Nutrition support - check for malnutrition, hyperkalaemia 2. Bone mineral management (P04, Ca, PTH), 3. Weight, diabetes, lipid management  Fluid restriction?  Energy: 125-146kJ/kg/day  PRO: 0.75-1g/kg/day  Pt’s on restricted PRO should receive thiamine, riboflavin, Vit B6  Vit D supp required is GFR1.1g/kg/day  Fluid: treatment based on oedema and HTN  Na+: treatment based on oedema and HTN  K+: treatment based on biohchem

Diverticular Assessment  Comprehensive diet Hx prior to diverticulitis  Fibre intake  Fluid intake  Compare fibre intake against requirements  Bowel movements, frequency, type  Constipation? (constipating mineral supps – iron, medications – morphine, codeine, pain meds) Intervention – diverticulitis  Bowel rest – NBM / clear fluids may be indicated  ONS during acute phase  Increase flood consumption  Progression to low-fibre diet  Progression to normal diet w/ fibre meeting req’s

Refeeding Syndrome Assessment  Energy and PRO intake  Recent intake and changes to usual intake  Determine extent and duration of inadequate intake  ETOH consumption  Financial issues/access to food/cooking facilities Medical Tests:  Na, K, Mg, P04, urea, creatinine, BUN, LFTs, thiamine, Hb, bilirubin, serum proteins, triglycerides Medications:  Antacids, diuretics, insulin, oral hypoglycemics, vitamin and mineral supps Intervention  Thiamine & multivitamin  Monitor K, Mg, P04 6-8hrs after commencing feeding  Monitor Na, K, Mg, P04, glucose, LFTs daily ( 7/7)  Monitor oral intake – meet req’s in 4-7 days  Monitor BGLs twice daily to prevent hypo/hyper’s  Daily weights  Fluid balance chart (prevent overload, oedema, CHF) Nephrotic Syndrome  Energy: 100-125kJ/kg/day  PRO: 0.75-1g/kg/day  Na restriction ( 80 mmol) & diuretics to treat edema  1L Fluid restriction (for pt’s with Acute Kidney Injury  Nutrition support  Hyperkalaemia  Fluid and salt management

Coeliac Assessment Gastroparesis Nutrient deficiencies (iron, folate, Ca, Vit D, B12)  Small Fibre intake IBS frequent meals  Severe symptomsimpacting Lactose QOL intolerance Chew foods well Bone mineral  Moderate-severe malnutrition Low fibre dietdensity (fibre slows down emptying)  FODMAP diet Intervention Avoid high fat foods GF foods, cross-contamination  Don’t drink with meals  Remain Address upright mineral1and vitamin deficiencies as hour after eating necessary  Try soft/mince-moist/pureed diet IBD  Screened for malnutrition  Nut Ax for patients: Pancreatitis - moderate-mild malnutrition - with Moderate-severe malnutrition a CRP >100 - anaemia >10% unintentional wt loss in 3-6 months  Malnutrition with anorexia/cachexia ONS, micronutrient supplementation Steatorrhoea  PERT

Cystic Fibrosis  Malnutrition and nutrition support  PERT  Salt replacement therapy and hydration  Vitamin therapy  Bone health...