Reference no: EM132436491

Problem: Mrs. Kouassi is a 44-year-old African from the Ivory Coast. Although she was diagnosed with hypertension about 11 years ago, it was left untreated. A year ago she was seen in the Emergency Department for fatigue, poor appetite, nausea and vomiting. She complained of shortness of breath, muscle weakness, and swelling of her lower legs. Her blood pressure reached 220/210. She was hospitalized, diagnosed with end-stage renal disease (ESRD), and started on hemodialysis. She currently goes to a dialysis center four times a week. She has not been working since she was diagnosed, and is receiving disability.  

Mrs. Kouassi is 5 feet 5 inches tall and weighs 145 pounds. When asked about her diet, Mrs. Kouassi states that she tried to follow the renal diet, but it is difficult because she likes to eat African foods such as palm oil and butter, rice, yams, soups, tea and dishes such as Fufu (cooked fine-blended cassava). She also likes fruits and vegetables, especially when they are combined with other foods such as in vegetable pizza. 

Required:

1. What diseases or conditions can lead to chronic renal failure?
2. What signs and symptoms of chronic renal failure did Mrs. Kouassi exhibit when originally diagnosed?
3. What dietary recommendations are appropriate for Mrs. Kouassi in terms of energy, protein, fat, fluids, sodium, potassium, calcium, and phosphorus?
4. How does hemodialysis help to prevent disease progression?
5. Why are protein restrictions relaxed once dialysis begins?
6. What recommendations would be helpful in teaching Mrs. Kouassi how to incorporate her ethnic foods into a renal diet?