COLLEGE OF NURSING Silliman University Dumaguete City Topic: Dietary Management for Renal Failure and Urinary Tract

Infection Time Allotment: 30 minutes Topic description: This topic focuses on dietary management for renal failure and urinary tract infection, the importance of the diet, types and examples, and home management for these types of diseases. Central Objectives: At the end of structured health teaching, the learners (patient and significant others) shall be able to acquire adequate knowledge and show positive attitudes towards the importance of dietary management of renal failure and UTI. T-L Activities: Socialized Discussion with visual aids. Evaluation: Oral Questioning
Specific Objectives: Content:

Within the 30-minutes structured health teaching guided by our visual aids, the learners will be able to:

I. Prayer Heavenly Father, we praise and glorify Your Holy name. We thank You for all the blessings youve shower upon us. We thank you for Your unending love and grace. Lord we humbly ask forgiveness for all the things we have done against you. Lord we ask for your wisdom and knowledge today as we will have our SHT about Dietary Management for renal failure and UTI as we impart this to our patients. Lord we also ask for your protection and healing for our patients and guidance as we take care our patients today. Bless us oh Lord now, in this all we pray in Jesus Name. Amen. II. Introduction Good Morning Mam/Sir. We are the level IV student nurses of Silliman University, under the supervision of our Clinical Instructor Asst. Prof .Ivan Pacatang. Before we proceed to our SHT we will first introduce ourselves, I am Sheena Joyce Velza and the other members of the group are Maui Jayson, Lovigene Laranjo and Gwyn Mark Yap. We are here this morning to do our Structured health teaching about Dietary Management for Renal Failure and Urinary Tract Infection; it includes the importance of diet, types and examples, also the foods that we need to avoid if we have renal failure and Home management for these disease. The nutrient intervention for urinary tract infection will also be discussed in our SHT. We would like also to ask a little of your time (at least 30 minutes) to listen. After the discussion, you can also ask for clarifications. We will start with the brief description or overview of renal disease and UTI. III. Overview of renal disease and urinary tract infection Renal failure results when the kidneys cannot remove the bodys metabolic wastes or perform their regulatory functions. Renal failure is a systemic disease and is a final common pathway of many different kidney and urinary tract diseases. The term urinary tract infection (UTIs) refers to a wide variety of clinical infections in which a significant number of microorganisms are present in any portion of the urinary tract. A most common form is cystitis, an inflammation of the bladder prevalent in young women. IV. Dietary Management for Renal Disease

1. Verbalized the importance of

dietary management for renal disease.

a. Importance of the diet Nutrition diet of the patients with renal failure has an integral role in the management of this kind of disease. Generally, diet modifications are important to reduce renal workload to delay or prevent further kidney damage, restore or maintain optimal nutritional status and to prevent other complications such as hyperetension and other central nervous system abnormalities. There are specific types and examples of foods that need to intake to prevent and manage the complications of this disease. b. Types and examples 1) Low sodium The need for sodium intake varies. Severe restriction and excess are to be avoided. In Kidney disease, high blood pressure and sodium are often related therefore, sodium restriction is one major dietary way of controlling hypertension. Examples of low sodium diet are unprocessed, fresh foods, such as fresh fruits, vegetables, lean meats, poultry, fish and unprocessed grains, tea and coffee are low sodium. 2) Low potassium Potassium is an important mineral in the blood that helps your muscles and heart work properly. Due to continued deterioration in the kidney, there is difficulty in controlling the potassium in the body, so, too much or too little potassium in the blood can be dangerous. Examples of low potassium diet are sour cream, white bread or rice, oatmeal, fruits such as grape, grapefruit and vegetables such as cucumber, green beans and cauliflower. 3) Low Phosphate A low phosphate intake is relatively easy to achieve when protein intake is restricted since it will also delay the progression of renal disease . Examples of low phosphate foods include fruits and vegetables, eggs, cream cheese, ice cream, peanuts, walnuts and sausage. Many dessert foods such as cake and cookies. 4) Low protein

2. Identify 2 types of the diet and

provide examples of food each.

The purpose of a low protein diet is to prevent worsening of kidney or liver disease. The diet is effective because it decreases the stress on the kidney or liver. Examples of low protein are vegetables, fruits, bread, cakes, pasta, corn and potatoes. People on a low-protein diet may also be given a protein substitute mixture or minerals and vitamin tablet to keep them healthy. 5) Fluid Control Total fluid intake must be guarded to avoid water Fluid isnt usually restricted unless there is an overload of fluid in the body which may result in pulmonary oedema (which is an accumulation of fluid in the lungs) and a shortness of breath. Where fluid restriction is indication, there should also be a sodium restriction to ensure there is no excess desire for fluid. Ice-cubes are useful to prolong any allowances and also to avoid water intoxication from overloading or dehydration from too little water.
3. Verbalized what are the foods

need to be avoided. c. Foods to avoid How to avoid sodium: Practical ways of avoiding salt in the diet include: not adding salt at the table, using herbs and spices in stead of salt when cooking, avoid processed foods which would be high in salt, e.g. are sausages, burger, ready meals, packet or tinned soup and salted snack (e.g. crisps, nuts). Also try to avoid take-away foods and foods that have been smoked or picked as much as possible as these foods contain a lot of salt. Bread should be keep to a maximum of 4 slices a day and cheese should not exceed 3 small portions per week.

How to avoid potassium: Foods which are rich in potassium and should be avoided include: chocolate, chips, coffee, wine, beer, dried fruit. One small serving of fruit (e.g. apple, pear, orange,) and a maximum of two small serving of vegetable (e.g., carrots, onions) can be included. Just one portion of milk and dairy products should be consumed daily. A small serving daily of boiled or mashed potatoes can be included.

How to avoid phosphate: Cheese is a rich source of phosphate and should be avoided. Milk is also a rich source and should be kept to an intake of 250ml daily. Certain types of fish (e.g. mackerel, crab, prawns) should also be avoided. Chocolate, nuts and baking powder are also all rich sources of phosphate. How to avoid excess protein: Protein isnt restricted as strictly as it once was. Avoid large portion of meat and diets based on meat as this is the main source of protein in the diet. Cheese and milk are also high in protein but are usually restricted anyway due to their high phosphate and potassium levels.

4. Enumerate at least 3 home-

based management regarding the diet nutrition of renal failure patient.

d. Home Management There are many things you can do at home to slow the progression of kidney disease:

5. Give at least 3 nutrient

interventions for urinary tract infection.

It is very important for people who have kidney failure to watch what they eat. Since your diet affects how you feel and how well your treatment works. Follow the eating plan created for you. Your eating plan will balance your need for calories with your need to limit certain foods, such as sodium, fluids, and protein You may also eat and drink so as to regulate your fluid balance, which means regulating your intake of fluids, including alcohol. Stay at a healthy weight. This can also reduce other complications such as hypertension, CAD. Keep your blood pressure monitor. Make exercise a routine part of your life. Since exercise may lower your risk for other complications and high blood pressure.

V. Nutrient intervention for Urinary Tract Infection a. Vitamic C Since bacteria that cause infections in the urinary tract cannot live in very acidic conditions, make sure that you increase your intake of vitamin C-rich foods such as bell peppers, limes, lemons, oranges, goose berries and guavas. Vitamin C promises to

fight urinary tract infections effectively and prevent recurrences. It helps to the immune system, fights infection and acidifies the urine.

strengthen

b. Vitamin A Vitamin A is essential for the development and maintenance of a healthy urinary tract. Vitamin A, usually in the form of beta-carotene in plants, helps cells form properly and maintains their integrity, making them more resistant to invasion from unfriendly bacteria. Good sources include carrots, pumpkin, squash, whole milk, eggs and meat. c. Increase fluid intake You must increase the quantity of fluids consumed. Drink 3 to 4 liters daily. it helps flush the system clean and purges out noxious wastes. Also include lots of soups, juices, barley water and coconut water in your daily diet d. Acid Ash diet The mineral elements in food are referred to as ash. These form a residue that you excrete in your urine. Foods are either acid-ash, meaning acid forming, or alkaline-ash, or basic forming. This categorization is determined by the foods influence on the pH of your urine. The acid-ash diet emphasizes eating acid-forming foods and restricts alkalineforming foods. Using an acid-ash diet can enhance the effect of the medications used to combat urinary tract infections. Consuming an acid-ash diet also helps when you need to excrete kidney stones that are made up of calcium and magnesium phosphates, oxalates and carbonates. Acid-ash foods include meat, shellfish, poultry, eggs, grain products and lentils. Alkalineash foods include milk, vegetables other than corn and fruits except for plums, cranberries and prunes. Acid-forming elements in foods that decrease the pH of urine include sulfur, chloride and phosphorus. Alkaline-forming elements in foods that increase urine pH include calcium, potassium, magnesium and sodium. Along with an acid-ash diet, your doctor may recommend avoiding caffeine, alcohol, pepper and carbonated drinks. e. Foods to be avoided Eliminate entirely (if you can) all meats and dairy products, eggs, refined grains, refined

starches, sugar, salt, alcoholic beverages, effervescent beverages (e.g. soda pop), junk food (including fast food), etc. These things are all Tamasic (acid-inducing) foods. They lower the body's natural alkalinity and promote sickness and disease. Tamasic foods are impure, rotten, or dead, and generally produce feelings of heaviness and lethargy. *** Try to increase your intake of wholesome foods like vegetables and fruits. You can also have these in fresh juice form by juicing them or pureeing them. VI. Evaluation 1. What are the importance of dietary nutrition for renal failure ? 2. Give atleast 3 types of diet and give example of each. 3. What are the foods that need to be avoided for the renal failure patient? 4. Give atleast 3 Home management for those who have renal failure? 5. What are the nutrient intervention for urinary tract infection ? give at least 3.

References: