DIET REGIMEN OF CHRONIC KIDNEY DISEASE STAGE V (LOW SALT, LOW FAT DIET)

PURPOSE: To give the patient the nutrients his body needs for daily living and to control his condition.
GOAL: Improve or maintain current nutritional status.
Objective and Subobjectives Content Outline Method of Instruction Time allotted (in min.) Resources Method of Evaluation
Following a 1hour teaching
session, the patient and/ or
guardian will be able to:
 COGNITIVE  What is low salt, low fat  Lecture 15 minutes  Reading Materials about  By the end of the session the
Define low salt, law fat diet diet or renal diet?  Providing reading Renal diet patient and/or guardian is
or the renal diet. o Fruits materials  List of foods he should and expected to be able to
o Explain the o Vegetables  Discussion should not avoid. summarize the lesson using
difference of his o Low fat dairy  Pamphlets about what should their own words.
diet with the product be avoided when under renal  Ask the patient questions about
normal diet; Effect o Whole grain diet. the concept of renal diet,
of renal diet. o Fish including how it works, how it
o Identify food  Effect of renal diet affects the body.
included in the o slow down kidney  Ask patient to participate in a
diet. damage and Pop Quiz about foods he can
o Identify which he prevent waste and and cannot eat.
could do from fluid buildup  Ask patient if he still have
those he must  Difference of renal diet questions or things he wants to
avoid to do. from other diets clarify.
o Discuss possible o Food variety
effects of o Amount of food
noncompliance to
 Do’s and don’ts when
diet
under a renal diet
o Avoid salt
o Lessen fat
 Effects of
noncompliance to diet
o Factors of patient’s
noncompliance
o Quality of life
 PSYCHOMOTOR  Renal diet and its  Demonstration 30 minutes  Flashcards of different foods  Test or quiz about what food is
 Choose different composition  Discussion (Fruits, vegetables, carbs, he allowed.
varieties of food o Potassium intake  Practice fluids, etc.)  Make the patient explain what
without compromising o Sodium intake  Demonstration video of how he learned after watching the
his diet needs o Fluid intake to monitor amount of fluid video
o Monitor amount of o Phosphorus intake  Demonstration of health care  Return demonstration of
intake and output  Proper measurement of provider on how to record and monitoring and recording fluid
of fluid. monitor body fluid intake and intake and output
 o Be able to intake and out take of output  Return demonstration of
construct planned fluid  Pamphlet for proper meal preparing renal diet meal
meals once the  Record and planning of planning.  Ask if he still has questions
patient got home meal  Demonstration of preparing about the pamphlet and if he
o Able to prepare  Food preparation meals has any queries.
meals aligned with o Amount of
renal diet vegetables per
serving
o Inspection of food
ingredients
o Avoid using too
much salt
o Avoid preparing
food that has too
much protein or
meet.
 AFFECTIVE  Address common  Discussion 15 minutes  Written Guide from the  Ask the patient regarding when
 Express any concerns concerns  Engage in a physician or health care to address concerns to the in-
 When to address  Give common scenarios question and provider charge health care provider.
concerns to the in- and examples answer  Active Participation of both  Ask the patient to come up with
charge health care  Explore feelings and conversation with health care provider and an example in expressing
provider concerns regarding the the patient or patient concerns.
renal diet guardian  Answers, explanations, and  Ask the patient on his queries
example scenarios coming with regards to the different
from the nurse, physician or discussions and guides given.
health care provider in-charge
TREATMENT TEACHING PLAN FOR CHRONIC KIDNEY DISEASE STAGE V
PURPOSE: Provide hemodialysis to prevent further complications and supportive care to treat kidney failure and can help to carry on an active life despite failing kidneys.
GOAL: The patient can help his/her body control blood pressure and maintain the proper balance of fluid and various minerals — such as potassium and sodium — in his body. The patient
learn about the hemodialysis process and know what to expect during treatment.
Time allotted (in
Objectives Content Outline Method of Instruction Resources Method of Evaluation
min.)
Sharing information about
how to manage CKD, the
patient will be able to:

COGNITIVE
a. Know more about Chronic kidney failure has no cure, but  Lecture  Time  Pamphlets will  The patient will
the treatments and treatment can help control signs and symptoms,  Providing reading allotment be given at the be able to give
dialysis and how to reduce complications and slow the progress of materials for the end of the health an oral
prevent the disease. The first priority is controlling the  Discussion health teaching. feedback.
complications and condition responsible for the kidney failure and teaching is
further worsening of its complications (e.g., controlling diabetes or 20 minutes.
kidney function in high blood pressure). Other treatments include:
his condition
Proper diet (protein management along with
salt, potassium and phosphorus restrictions
may help slow disease progression)

 Daily exercise
 Avoidance of dehydration
 Avoidance of smoking and other
tobacco products
 Avoidance of alcohol and illegal drugs
 Avoidance of substances that are toxic
to the kidneys, such as NSAIDs
 Treating complications (e.g. treatment
of anemia with erythropoietin to
induce the production of more red
blood cells or phosphate-binding
medications to reduce the amount of
phosphate in the blood, which will
increase the amount of calcium
available to the bones)

In end-stage kidney disease (when kidney

function is reduced to 10-15 percent or less of
capacity), conservative measures as outlined
 above are no longer enough. Dialysis or kidney
transplant become the only options to support
life.

Importance of medications
and dialysis

b. What is  The main goals of medication are to

hemodialysis slow progression of the disease and
monitor and correct disease-associated
complications and comorbidities while
treating the underlying etiology.

 If your kidney disease becomes very

severe and crosses a point where
there’s not enough function to maintain
the body, then you need either a
transplant or dialysis.

PSYCHOMOTOR
Prescribe Oral Medication
 Know the  Adherence to medication in chronic  Discussion  Time  Reading Materials  The patient will
importance of kidney disease (CKD), is a key  Providing Written allotment for  Written be able to give an
adherence to component of effective disease Instruction the health Guidelines oral feedback.
prescribe oral management.  Engaged in teaching is 20  List of prescribed
medication question and minutes. medication  The patient will
 Dosage adjustment is recommended in answer about the  List of the accept the dialysis
 Know the correct patients with compromised renal oral medications schedule of proper and will know the
dosage and function with stage 5 and/or those and the proper time on taking the how to properly
frequency of undergoing hemodialysis. The risk of dosages oral medication initiate the
prescribe medication renal failure is directly related to drug  procedures on
infusion time and dosage. hemodialysis.
 Consequence of
noncompliance  Medication noncompliance has a
harmful impact on reaching therapeutic
goals of delaying the progression of
chronic kidney disease (CKD).

 List of Oral  List of Oral Medicines to be taken and

medications, dosages dosages:
 and when to
properly intake - Amlodipine 10mg/tab, once a day
in the morning
- Irbesartan 300mg/tab, once a day
in the evening
- Carvedilol 25mg/tab, twice a day
- Clonidine 75mcg/tab, twice a day
- Atorvastatin 20mg/tab, once a day
before sleeping
- Sevelamer 80mg/tab, three time a
day
- NaHCO3 tab, twice a day
- Febuxostat 40mg tab, once a day
- FeSO4 + FA tab, twice a day
- CaCO3 tab, three times a day

Importance of medications
and dialysis

 How hemodialysis  Dialysis is a treatment that takes over

work your kidney functions if those organs
stop doing their job.
 Hemodialysis: Your blood is put
through a filter outside your body,
cleaned, and then returned to you.
 Catheter Method of  Catheter METHOD (central venous
hemodialysis catheter): This method is an option if
you need to start hemodialysis very
quickly. A flexible tube (catheter) is
put into a vein in your neck, below
your collarbone, or next to your groin.
It’s only meant to be used for a short
time.
During hemodialysis, you’ll sit or lie
back in a chair. A tech will place two
needles in your arm where the fistula
or graft is located. A pump in the
hemodialysis machine slowly draws
out your blood, then sends it through
another machine called a dialyzer. This
works like a kidney and filters out
 extra salt, waste, and fluid. Your
cleaned blood is sent back into your
body through the second needle in
your arm.
Expressing queries
 The patient/guardian  Long-term stress can raise the patient’s  Discussion with a  Time  Written  The patient and
should address blood pressure and blood glucose that friend of family allotment for Guidelines guardian will be
his/her concern with lead to depression. Some of the members the health  List of prescribed able to give an
regards to the medication that the patient is taking to  Providing Written teaching to medication oral feedback.
patient’s medication. manage his kidney disease are also Instruction to serve the patient  Schedule of
healthy ways to cope with stress. A as guide for the and guardian proper time to
trusted friend or family member can patient’s is 15 minutes. take oral
take notes of the dosages of the medication medication
medication to help the patient.