Ndt Final Proposal

CHINESE GENERAL HOSPITAL COLLEGES 286 Blumentritt Street, Sta. Cruz Manila College of Nursing SY: 2019-2020

Nutrition and Diet Therapy Laboratory N-1025 NDT lab MENU PROPOSAL: For patient with Acute Renal Failure

Breakfast Main course: Oven Omelet with fresh fruits salad Beverage:

Water

Lunch Main course: Herbed Chicken with garlic mushroom and Rice Beverage: Water Dinner Main course: Pasta Primavera serve with water melon Beverage: Water

Dela Paz, Cindy L. II B- BSN MS. AUBREY DAYRIT November 23, 2019 1

I.

TABLE OF CONTENTS

Page

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II.

Introduction about the Chosen Menu and Rationale

Acute kidney failure occurs when your kidneys suddenly become unable to filter waste products from your blood. When your kidneys lose their filtering ability, dangerous levels of wastes may accumulate, and your blood's chemical makeup may get out of balance. This disease is also called acute renal failure or acute kidney injury develops rapidly, usually in less than a few days. Acute kidney failure is most common in people who are already hospitalized, particularly in critically ill people who need intensive care. (Mayo Clinic, 2019) Breakfast: This recipe is not only mouthwatering but are also packed with essential nutrients that our body needs to help prevent forming diseases most especially for kidney failure. Oven Omelet is so easy and flavorful, you’re going to love to have breakfast again. It is inexpensive, easy to prepare and most particularly healthy for our body. I chose this menu as a breakfast to make my patient have enough calories since for acute kidney failure, you must have a 3000 kcal for a whole day but small amount of proteins in their diet. For omelet I'll make sure that the protein should have lower proteins even though it is not exact to what she need there's always allowances for every distribution. So it is still right for the condition of my chosen patient. Aside from this I also prepare a fresh fruits salad to make it balance and to have some sweets taste. These fruits are good for acute kidney failure, it’s serves as dessert and the benefits of these are really amazing because these are antioxidants and good source of different vitamins. Lunch: Tender and juicy chicken in the most amazing creamy and delicious garlic mushroom sauce. This menu would be your favorite as always plus it is very healthy especially those who have renal failure. Chicken and mushroom will truly taste good. Mushroom are an excellent source of B vitamins, copper, manganese and selenium. In addition, they provide a good amount of plant-based protein and dietary fiber it is also lower in potassium than other ingredients, making them a smart choice for those following a renal diet (Healthline, 2019). Aside from this the chicken breast serve small amount since the patient do not recommended to consume a lot of protein. There are many more ingredients that complete this delicious menu furthermore the oil I used is olive oil, this is a healthy source of fat and phosphorus-free, making it a great option for people with kidney disease. Frequently, people with advanced kidney disease have trouble keeping weight on, making healthy, high-calorie foods like olive oil important. According to health line the majority of fat in olive oil is a monounsaturated fat called oleic acid, which has anti-

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inflammatory properties. For making this menu perfect serve it with 1 cup of rice, rice is good source of carbohydrates. Dinner: This easy, fresh, healthy pasta with vegetables is the perfect dinner meal. The pasta primavera gives the patient full tummy and delicious taste. It is very healthy since the main ingredient which is the pasta is different from normal noodles that serve from restaurant or hospitals. For this meal I used Gluten free pasta and the flavor of this dish comes mainly from the cooked vegetables such as cauliflower and carrots. Cauliflower is a nutritious vegetable that is high in many nutrients, including vitamin C, vitamin K and the B vitamin folate. It’s also full of anti-inflammatory compounds like indoles and an excellent source of fiber (Heathline). All the meal are good choices for patient with acute renal failure.

III.

Client’s Profile: Sex: Female Weight: 70 kg Height: 5’8 or 172.72 cm Occupation: Head Chef with long working hours Age: 55 years old Sleep hours: 6 hours Food likes: cheese, beef, pork, fruits and vegetables and chocolate Food Dislike: none Food Allergies: None

IV.

Computation A. Desirable Body Weight Weight (lbs) x 703 BMI= Height(inchs) = 23.41(Normal)

=

154 lbs 2 x703 (68)

Tannhauser 68 x 2.54 = 172.72 172.72cm – 100 cm = 72.72 cm = 72.72 x 10 % = 7.272

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= 72.72– 7.272=65.45 kg (DBW in kg) = 65.45 kg x 2.2 lbs = 143.99lbs (DBW in lbs) B. BMR (Rule of Thumb) = IBW (in kg) x basal need (per gender) x 24 hrs/day =65.45 kg x 0.9 kcal/kg/hr x 24 hrs/day = 1413.72kcal/day PA = BMR x Types of Activity = 1413.72 kcal/day x 100% = 1413.72kcal/day SDA = (BMR + PA) 10% = (1413.72 kcal/day + 1413.72 kcal/day) 10% = 282.74kcal TER = 1413.72kcal/day+ 1413.72kcal/day + 282.74kcal TER= 3110.18 or 3150 kcal/day C. Distribution of Total Energy Requirement (TER) per meal The dietary prescription of 3150 kcal/day is divided onto 4 categories, namely; breakfast at 35%, lunch 35% and dinner 25% and snacks at 5%. Breakfast: 35% Lunch: 35% Dinner: 25% Snack: 5% Breakfast Lunch Dinner Snacks

3150x 35% = 1102 kcal 3150 kcal x 35% =1102 kcal 3150kcal x 25% = 787 kcal 3150 kcal x 5 % = 157 kcal

Distribution of Total Energy Requirement (TER) in Lunch, Breakfast, Dinner The distribution of Carbs, Proteins, and fat are over all 100% every meal. As you can see the carbs are exceed to normal average which is 55 to 70%. It is because of the condition of the client. She has acute renal failure and for this disease the client should have at least 3000 kcal a day. However, the protein content in her food serve a very small amount so that her meal do not make her condition more dangerous. The carbohydrates are serves larger for energy than the two which are fats and protein. For the protein, the serving of it is depending from weight of the client. Since she is 70 kg it would be divided to 0.25 to come up to the protein needed every meal. The result of this computation is 17 grams per meal of protein. Additionally according to the book basic nutrition and diet therapy the general diet management for client who has kidney problems should be very low in protein which is do not exceeds to 20 grams and for the carbs are relatively high. 5

1. Breakfast The kcal breakdown for breakfast is 1102 kcal Breakfast CHO 74% CHON 6% FATS 20%

kcal 815 kcal 66 kcal 220 kcal

Grams 203 g 16 g 55 g

2. Lunch The kcal breakdown for lunch is 1102 kcal. Lunch CHO CHON FATS

74% 6% 20%

kcal 815 kcal 66 kcal 220 kcal

Grams 203 g 16 g 55 g

3. Dinner The kcal breakdown for Dinner is 787 kcal Dinner CHO 80% CHON 5% FATS 15%

kcal 630 kcal 39 kcal 118 kcal

Grams 157 g 10 g 14 g

V. Meal Plan A. General Ingredients per Serving I. Breakfast Main course: Oven Omelets with fresh fruits salad Beverage:

Water

Ingredients Cauliflower, chopped Malunggay carrot

Measurement 1 cup 1/2 cup 1 cup

6

egg cheese Bell pepper diced

1 pc 1/2 cup 1 small cup

Onion Chopped

1/2 cup

Hot sauce

1/2 tsp.

Black pepper Butter

1/2 tsp 4 tsp.

Fresh Fruit Salad Water melon

2 slices

Papaya

2 slices

strawberries

6pcs

Mango

4 slices

Honey

6 tbsp.

Boiled corn

1 cup

B. Cooking Procedure and Sample food presentation: Preheat oven to 350 degrees. Mix all the ingredients of omelets in a bowl then proceed to the other procedure below. 1. Line muffin tin with foil baking cups and spray with cooking spray 2. Whisk all ingredients in a bowl. 3. Spoon the mixture to fill each baking cup. 4. Bake 20 minutes, or until they feel firm to the touch in the center. 5. Cool 5 minutes on wire rack before eating. 6. Once cold, wrap extras in plastic wrap to store in a freezer-safe bag. You can reheat them to enjoy later. For Fresh fruits, cut it into square and mix well with honey and for corn, boiled it with water for 1 hour or until it cooked. Serve everything and the muffins with butter on top.

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II. Lunch Main course: Herbed Chicken with garlic mushroom and Rice Beverage: Water

Ingredients Chicken Olive oil

Measurement 1 slice size of fist 2 tbsp.

Low Salt

1/2 tsp.

Fresh rosemary

2 tbsp.

lemon

2 slices

Lemon juice

2 tbsp.

White wine

1/2 cup

Garlic, chopped

2 cloves

Butter

2tbsp

Mushroom

2 cups

Grapes

12pcs

Ube halaya

4 tbsp.

Yogurt

½ cup

Cooking Procedure: Preheat the oven to 400 degrees. 1. Brush top and bottom of Chicken fillet with olive oil and flavor with seasoning blend and chopped rosemary. 2. Place seasoned chicken on a piece of aluminum foil. 3. Top with 1 lemon slice, 1 tablespoon of lemon juice, ½ tablespoon of wine. 4. Wrap chicken tightly in the foil packets. 5. Place the foil packets in the oven and bake for 15-20 minutes. Alternate: place foil packets on hot grill and cook for 10 minutes, flipping once. 6. After frying the with garlic mushroom, place on top of chicken to make it more delicious and perfect.

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III. Dinner Main course: Pasta Primavera serve with side dish watermelon Beverage: Water Ingredients

Measurement

Macaroni

2 cups

Carrot

1 /2 cup

Cauliflower

1/2 cup

Low-sodium chicken broth

1 cup

All-purpose white flour

2 tbsp.

Whipping cream

10tbsp

Condensed milk

2tbsp

Cheese

3 tbsp.

Watermelon

7 slices

Cooking Procedure: 1.

Cook pasta and vegetables in separate pots according to package directions, but omitting salt. Drain.

2.

Pour low-sodium chicken broth in a medium-sized stockpot and heat on low heat.

3.

Add flour to broth whisking vigorously to avoid clumps from forming. 

4.

Add half and half and garlic powder and stir. 9

5.

Simmer on low heat for 5 to 10 minutes until mixture thickens slightly. Stir occasionally while simmering.  

6.

Add cooked vegetables and pasta. Cook until heated through.

7.

Sprinkle with Parmesan cheese and serve.

of

Kcal

Distributions

Dietary prescription: 1102 kcal g 55 g

C. T a b l e Vitamins

with 203

g

16

Oven Omelettes with fresh fruits salad Food Group

No. of # of Exchang e

CHO

Ingredient

Quantity 2 cups 2cups ½ cup

-

I. Veg A

5

Cauliflower Pepper Malunggay

Veg B

2

Onion Carrot

½ cup raw ½ cup raw

6

14

Strawberries Papaya watermelon Mango

4 pieces (8x7x1 ½ cm each)

140

II. Fruits

CHON

-

-

Fats

Kcal

-

-

-

32

-

560

Vitamins These three ingredients are good source of vit. A & C Good source of dietary fiber, and folic acid and vit. A antioxidant

III. 10

Milk IV. Rice V. Meat and Fish

1

Boiled corn

1 cup

2

Egg Cheddar cheese

1pc 1 slice (6x3x1 1/2 cm)

Med. fat

23

2

-

-

16

12

100

Rich in vitamin C, magnesium, B vitamins

172

These two are good source of protein

VI. Sugar

6

Honey

6 tablespoon

30

-

-

120

Good source of pantothenic acid, niacin and riboflavin

VII. Fat

4

Butter

4 tsp.

-

-

20

90

Good source of Vit. D

Total

199g

18 g

32g

Allowances

+5

+5

+5

1074 kcal +50

Table of Ingredients per Serving in Lunch Dietary prescription: 1102 kcal

203 g

16 g

55 g

Herbed Chicken with Mushroom and Rice Food Group

No. of # of Exchang e

Ingredient

CHO

CHON

Fats

-

-

-

-

2 cups

12

1

-

52

Quantity

I. Veg A

Kcal

Veg B

4

Mushroom

II. Fruits

12

Grapes

12 pieces

120

-

-

480

1

Yogurt

½ cup

12

8

5

125

1

Steamed

1 cup

23

2

-

100

III. Milk Low fat IV. Rice

Vitamins

rich in the B vitamins contain vitamin C, betacarotene, powerful antioxidants Rich in vitamin B12 Good 11

source of energy, carbohydrat es

Rice V. Meat and Fish

1

Chicken

1 piece

-

8

1

41

Lean Meat VI. Sugar

4

Ube halaya

2tbsp

20

-

-

80

VII. Fat

6

Olive oil Butter

2tbsp 2tbsp

-

-

30

270

Total

187g

19 g

46 g

Allowances

+5

+5

+5

Good source of protein Good source of energy Large Amounts of Antioxidants and vit. D

1148 kcal +50

Table of Ingredients per Serving in Dinner Dietary prescription: 787 kcal

157 g

10g

14g

Pasta Primavera Food Group

No. of # of Exchang e

Ingredient

Quantity

CHO

CHON

Fats

Kcal

I. Veg A

1

Cauliflower

½ cup

-

-

-

-

Veg B

2

Carrot onion

½ cup ½ cup

6

2

-

32

II. Fruits

7

Watermelon

7 small slices

70

-

-

280

2

Macaroni

2 cups

46

4

-

200

III. Milk Low fat IV. Rice

Vitamins Good source of vitamin c Good source of vitamin A Good source of vitamin A Good source of carbohydrat es and 12

protein, and low in fat V. Meat and Fish

-

VI. Sugar

VII. Fat

6

Condensed milk

3

Whipping cream

6 tbsp.

30

-

-

3 tbsp.

-

-

15

Total

152 g

6g

15

Allowances

+5

+5

+5

120

Good source of Selenium Riboflavin (B2)

135

vitamin A, choline, calcium, and phosphorus

767 kcal +50

Free Food in all meals: Lemon Juice - -Good source of vitamin C. Also contain vitamins B5, B6, B1, B2 and potassium, calcium, copper, and iron Low-sodium chicken broth- It may protect the joints, and may help fight osteoarthritis and rich in calcium. All- purpose flour- very good source of selenium, riboflavin, niacin, and thiamine. Hot sauce- good source of vitamin A Black pepper- This food is low in Saturated Fat, and very low in Cholesterol and Sodium. Rosemary- good source of iron, calcium, and vitamin B-

VI.

Costing (General and per Serving)

Food Item Cauliflower Malunggay carrot

Household measure 1 ½ cup ½ cup 1 ½ cup

Measure in grams 190 g 15 g 190 g

Wholesale price ₱70-₱80/kilo ₱10-₱30/kilo ₱50-₱70/kilo

Price per serving 20 pesos 5 pesos 10 pesos 13

egg cheese Bell pepper Onion Hot sauce Black pepper Butter Water melon Papaya strawberries Mango Honey Boiled corn Chicken Olive oil Low Salt rosemary Lemon White wine Garlic, Mushroom Grapes Ube halaya Yogurt Macaroni All-purpose flour Whipping cream

1 pc 3 ½ tbsp. 1 small cup ½ cup ½ tsp. ½ tsp. 6 tsp. 9 slices 2 slices 6pcs 4 slices 6 tbsp. 1 cup 1 slice 2 tbsp. ½ tsp. 2 tbsp. 2 tbsp. ½ cup 2 cloves 2 cups 12pcs 4 tbsp. ½ cup 2 cups 2 tbsp. 10 tbsp.

90 g 40 g 50 g 68 g 2g .5 g 36 g 220 g 100 g 250 g 230 g 72 g 128 g 250 g 24 g 3g 20 g 24 g 34 g 5g 256 g 300 g 48 g 68 g 256 g 24 g 100 g

₱50 per 10 pcs ₱90-₱100/pc ₱60-₱90/kilo ₱50-₱60/kilo ₱100/bottle ₱50/kilo ₱120-₱130/pc ₱60/kilo ₱40/kilo ₱150/kilo ₱100-₱120/kilo ₱130/bottle ₱70-₱80/kilo ₱150/kilo ₱200/bottle ₱20-₱30/kilo ₱100/kilo ₱60-₱80/kilo ₱400/bottle ₱30-₱40/kilo ₱90-₱100/kilo ₱120-₱150/kilo ₱50-₱60/kilo ₱40 ₱80-₱90/kilo ₱50-₱60/kilo ₱60-₱70/kilo

5 pesos 15 pesos 10 pesos 2 pesos 2 pesos 1 peso 30 pesos 20 pesos 20 pesos 50 pesos 20 pesos 10 pesos 25 pesos 50 pesos 6 pesos 5 pesos 5 pesos 10 pesos 75 pesos 2 pesos 50 pesos 15 pesos 10 pesos 20 pesos 40 pesos 5 pesos 5 pesos

Condensed milk

2 tbsp.

24 g

₱40-₱45/kilo

5 pesos

Low sodium chicken broth Steam rice

1 cup

128 g

₱50-₱80/kilo

20 pesos

1 cup

128 g

₱50/kilo

15 pesos

Total

₱ 590.00

VII.

Materials and Equipment •1 Frying Pan •1 Saucepan •1 pair of tongs •1 Chopping board •2 Kitchen Knife •1 peeler •1 Strainer 14

•2 Spatula •3 Spoon •3 Fork •1 large basin •2 Bowl •3 Dinner Plate •2 Drinking Glass •2 small containers •Table napkin

References: https://www.healthline.com/nutrition/best-foods-for-kidneys? fbclid=IwAR23rjJEL47F0BaeZgsARIYy1r55WCyQX0FHzfqFFRiEDzhFK7KuUPT7_5Y# section22 https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expertanswers/high-protein-diets/faq-20058207 https://www.webmd.com/a-to-z-guides/what-is-acute-kidney-failure Basic Nutrition and Diet Therapy Textbook, second Edition. Maria Lourdes CruzCaudal, RND, MEM.

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