Medical Nutrition Therapy 2 Exam 2 Questions And Answers 2024/2025 Updates
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Medical Nutrition Therapy 2
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Medical Nutrition Therapy 2
Medical Nutrition Therapy 2 Exam 2 Questions And Answers 2024/2025 Updates
February 13 was a snow day so February 15. Mnt for renal disorders and fluid and electrolyte balance.
• What is the role of the kidney? ANS o Maintain balance of fluids, electrolytes, and organic solutes.
o Control b...
Medical Nutrition Therapy 2 Exam 2 Questions And
Answers
February 13 was a snow day so February 15. Mnt for renal disorders and fluid and electrolyte
balance.
• What is the role of the kidney? ANS o Maintain balance of fluids, electrolytes, and organic
solutes.
o Control blood pressure (renin angiotensin mechanism).
o Produce of erythropoietin (EPO).
o Maintain of calcium phosphorous homeostasis (formation of active vitamin D, 1,25
dihydroxycholecalciferol or 1,25 - [OH]2D3.
o Maintain acid base balance.
• In maintaining balance of fluids, electrolytes and organic solutes for kidney function what are the
factors? ANS o Oliguria.
o Azotemia.
o renal function.
o and renal failure.
• what is oliguria? ANS o Oliguria is urine volume less than 500 milliliter per day solute load
comprised of nitrogenous wastes.
• What is azotemia? ANS o Azotemia is the accumulatio of nitrogenous wastes in the blood.
o This is really the hallmark to notice that the kidney is declining.
She moved on to fluid and electrolyte balance and acid base basics 8:00.
• what is fluid balance? ANS o Fluid balance equals fluid in minus fluid out.
,• Certain foods can provide more water than others like fruits and lettuce but what you get from that
is metabolic water and also when we oxidize nutrient we also produce water from the electron
transport chain but really we just think about water but if the fluid restrictions are tough you may
have to pay more attention to that. ANS
• What are the method for estimating fluid needs? ANS o weight in kilogram time 25 to 34
mililiter equal milliliters of fluid required daily
25 milliliter per kilogram for congestive heart failure or renal disease.
30 milliliter per kilogram for average adults.
35 to 40 milliliter per kilogram for patients with infection or draining wounds.
o 1 milliliter per kilocalorie of intake = equal milliliters of fluid required daily *.
*If a patient's calorie intake is poor or low, fluid needs may be underestimated.
o Average healthy adult: 25 to 40 milliliters per kilogram of body weight.
Adult 55 to75 years: 30 milliliters per kilogram of body weight.
Adult older than 75 years: 25 milliliters per kilogram of body weight.
o Dietary Reference Intakes: adequate intakes (AIs) for water.
Adult males older than 19 years of age: 3.7 liters per day.
Adult females greater than 19 years of age: 2.7 liter per day.
• In ICU they may do fluid requirement based on surface area because if you have a burn patient
there is a big attempt to keep the temperature of a room at a certain rate so they are not loosing a lot
of water and fevers. She said that she might ask on the exam that to give an example of one or the
other or why is it important in a clinical scenario. ANS that is right
• What are the consideration for fluid excretion? ANS o Obligatory fluid.
o Facultative fluid.
o Renal solute load (RSL).
• What is obligatory fluid? ANS o Excretion represents the minimum fluid necessary to remove
waste materials excreted in urine.
, o some people that may have bladder control problems may be purposely dehydrated and drink less
water but we are hoping that they can clear waste product because if not the body will pull from its
other sources to excrete and cause consequential dehydration.
• How much waste product is a normal healthy adult able to excrete per liter? ANS o Kidneys of
normal healthy adults can concentrate 1200 to 1400 milliosmole per liter (obligatory).
o If the renal solute load is 600 milliosmole:
600 milliosmole divided by 1200 milliosmole per liter = .5 liters
600 milliosmole divided by 1400 milliosmole per liter = .428 liters
So, 430 to 500 milliliters is the minimal amount of fluid needed to accommodate a renal solute load
of 600 milliosmole.
• What is facultative fluid? ANS o Facultative is when Excretion depends on the tubular
resorption rate of the kidneys and fluctuating body needs.
o This refers to a healthy person with a healthy kidney who can get 1.5 to 3 liter of parenteral
nutrition (TPN) without a worry.
• What is the volume of urine output that works most efficiently for the kidneys? ANS o Kidneys
work most efficiently when urine output is 1.5 to 2 liter times RSL. (facultative)
1.5 to 2 liters times 600 milliosmole equals 900 to 1200 milliliters necessary for most efficient
clearance of 600 milliosmole.
• What is renal solute load (RSL)? ANS o Renal solute load Is comprised of metabolic products
from protein metabolism (mainly urea) and the electrolytes sodium, potassium, and chloride.
o Renal solute load is just milliosmoles.
• What is the formula for renal solute load? ANS o Renal solute load = (grams of protein times
5.7) + milliequivalent (sodium + potassium + chloride).
o She expects us to know for the exam the contributors to renal solute load which is sodium
potassium and chloride.
• What is a consideration for renal solute load? ANS o Lipids and carbohydrates do not
contribute to renal solute load, only protein and electrolytes Na+, Cl- and K+.
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