Dietetics for NursesProudfit, Fairfax T. (Fairfax Throckmorton)
Science
Dietetics for Nurses
Proudfit, Fairfax T. (Fairfax Throckmorton)
Diet in disease
The test diet is a mixed diet containing known amounts of water,
nitrogen, and chloride, together with the food diuretics (purins,
salt, and water), as can be seen. The diet is divided into unequal
portions containing known but varying amounts of fluid, nitrogen, and
salt. Two-hour specimens are collected from 7 A.M. to 9 P.M., and one
night specimen is obtained containing all the urine passed between 9
P.M. and 7 A.M. Each specimen is analyzed for volume, specific
gravity, total nitrogen, nitrogen concentration, total chloride, and
chloride concentration.
~Purpose of Tests.~--The purpose of the test is to find out to what
extent and in what manner the diseased kidney under stimulation by the
various diuretics taken in the food reacts in putting out the varying
amounts of salt.
Dr. O'Hara likewise describes another test known as ~The Added Urea
and Salt Test~, which was first described by von Monakow and also
carried out in the Peter Bent Brigham Hospital. The method used was as
follows:
ADDED UREA AND SALT TEST
Patient is given 75 grams of protein, 4 grams of sodium chloride, and
1500 c.c. of water, with a caloric value of from 2000 to 2200
calories. After the output of fluid, salt and nitrogen reaches an
equilibrium on this diet on one day 10 grams of additional salt is
given and several days later the patient receives 20 grams of urea.
This order may be reversed. The daily output of urine, salt, and
nitrogen is determined and charted. After the salt and nitrogen is
added to the diet in normal individuals, their excretion after
forty-eight hours returns to its previous level. In diseased kidneys
this may not be the case.
~Value of Tests.~--Thus it is seen that in these tests for kidney
functions, an effort is made to determine the extent of damage wrought
by the disease upon the renal organs and the manner in which they
react under definite circumstances. However, it is not so simple as it
would seem to formulate a dietary based on the findings resulting from
the renal tests. Notwithstanding this, these tests are coming more and
more into use, both in hospitals and private practice, and a nurse
must understand just how they are carried out, and must realize that
unless her part is performed with absolute accuracy the entire value
of the test will be obliterated. Too much stress cannot be laid upon
this phase of the test, if it is to be of any value whatsoever in
determining the condition of a diseased kidney.
CHRONIC INTERSTITIAL NEPHRITIS
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