Labs Report And Forms > Nursinghomelunchguide

Sack Lunches for Dialysis What are the basics for the renal diet in Long Term Care? • • • • •

Fluid limits (1000 cc + urine output or per MD orders) High protein (minimum of 1 ounce per 10 kg of body weight) Limited Potassium (2000 to 4000 mg per day ) Limited Phosphorous (l/2 cup serving of dairy product per day and avoid or limit dried peas, dried beans, nuts, bran) Low sodium (No added salt or per MD orders)

Diets may vary for patients and it is always a good idea to keep in touch with your RD at the dialysis unit to see how a patient is doing. As with any patient, the least restrictive diet is the goal. Some patients may not even require renal restrictions. In addition, many “Renal” Diets provided by the menu companies are set for pre-dialysis protein goals (limiting protein) which are not appropriate for dialysis patients. Labs are done on a monthly basis and can be accessed by calling your resident’s dialysis Facility.

Many of our residents living in long-term care settings have long rides on local bus or transport services. They often miss meals due to transportation times. In addition approximately 40% of patients are diabetic and therefore need timely meals to prevent low blood sugar reaction. How to balance the meal time, while these patients are out of the facility for 5 or more hours, during standard meal times is often a problem. During dialysis these patients often have one arm immobilized. So opening cans, self-feeding etc. can be difficult for even the most skilled.

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Provide larger portions for meal and snack times the patient is in the long term care facility. Send a sack lunch (ideas are provided) for the patient to have right before or after dialysis. Eating while on dialysis can complicate the treatment because of: Choking risks during dialysis Sanitation and foodborne/ bloodborne risks Risk of lowering blood pressure during dialysis Nausea and vomiting on dialysis If lunch is the largest meal, and a dialysis patient is missing this meal, it may be appropriate to save the lunch meal and serve it at dinner. Dialysis patients will often do better with this lunch meal, than the soup, salad and sandwich commonly served at dinner. Schedule tube feedings, supplements, and snacks around the dialysis schedule

Dialysis Day Sack Meals

Main Dishes OK for Renal Diet Tuna Salad or Tuna Fish Sandwich Low Sodium Lunchmeat Sandwidh Chicken Salad Turkey/Chicken Sandwich Peanut Butter and Jelly Sandwich Hard-Boiled Egg or Egg Salad Sandwich Cold Fried Chicken Meatloaf Sandwich Bagels and cream Cheese Side Dishes Prepared fruits (apples, pineapple chunks, grapes, berries) Canned fruits, fruit cups, applesauce Pretzels, rice cakes, graham crackers, Ginger snaps, Vanilla wafers or other plain cookies Lightly salted popcorn or kettle corn Carrot / Celery Sticks Jello Cups Dry Cereal Box for a snack

Main Dishes Not Appropriate for Renal Diet Salty Lunchmeats like Saklami, Ham, pastrami, corn beef, hot dogs Items that must be reheated or refrigerated. Anything that must be cut, might drip or will fall apart. Potato Chips or other salty snack chips Dried fruit like raisins, nuts or trail mix Items that are not eacy to open with one hand Fruits that have to be peeled or prepared If a patient is having swallowing difficulties, please do not send beverages. Please alert dialysis unit of swallow Precautions

Binders

Nutrition supplements such as: Ensure, Boost, Nepro, MagnaCal, etc, are often a good way to add protein and calories while the resident is away

Please send Phosphate Binders with lunches, snack, or supplements so that they may be taken with food as prescribed, and no dose is missed.