Question

ments for th This assignment will require you to integrate several aspects of a patient's heath and well-being by developing an Educational Packet for your patient. You will need to consider a patient's physical, pathological, cultural, and social health. Create an entire education packet for your patient. This should include what the patient needs to know from all aspects of care. Include Care Plans for the pathology and treatment, and an Educational Packet with all information needed from the start of treatment to potential outcomes related to that treatment. You have an entire week to complete the assignment. Be creative and make your Packet as unique as you would like. If you were in this type of position, what would you want to know about a new diagnosis? What should you expedt to happen at different stages or with each encounter into the unknown? How would you like it presented to you? How would patients we encounter form different cultures handle such information? The Scenario- A 65 year old woman has just been admitted to your unit. She is Middle tern and this is her first hospital experience. She was admitted with ESRD and is very "fragile" at this time from a physical aspect. She has been in fair health and recently moved in with her eldest son and his family. The house is two stories and her bedroom is on the second floor. Until this time she has been independent and caring for herself. Recently she became a widow and it was decided she would move in with the family Her medical history is not extensive and she is not willing to seek help very often. Only since the recent onset of signs and symptoms that have weakened her has she began to be more consistent in her willingness to seek out care. She is nervous and anxious. She is skeptical of others and asks if her family can stay with her during this time. She has a history of Hypertension and takes medication for it. She has had a history of multiple UTIs and vesicoureteral reflux Her medication list is as follows - Zestril 20mg PO QD, Ferrous sulfate 325mg PO QD, Vitamin B 1 PO QD, Vitamin D 50mcg PO QD.

pls help me out with my assingment

Answer 1

The patient is a case of End stage renal disease and has to undergo dialysis three times a week . The patient has no knowledge about the disease and the treatment modalities and is anxious about it so being a nurse it's my responsibility to clear all her doubts by encouraging her to express her concerns and providing a health teaching about the disease condition :-

ESRD is the loss of renal funciton characteried by a glomeular filtration rate (GFR) less htan 20% of normal.

The final stage of chronic renal failure (slow, progressive loss of kidney function & glomerular filtration) Ends fatally with uremia (urine in the blood)

# The most common causes of ESRD :-

Diabetic Neuropahty, hypertenson, glomerulonephritis, systemic lupus, cystic kidney disease

# Clinical Manifestations of ESRD :-

Early: Nausea, apahty, weakness, fatigue

Late: may have frequent vomiting, increasing weakness, lethargy & confusion; may complain of restless leg syndrome, paresthesia, sensory loss, persnality changes, anxiety, irritability, hallucinations, seizures & coma in late stages

# Respirations in ESRD may change to

Kussmaul patern (deep & rapid respiration), with deep coma following

Skin becomes pale and dry with yellowish hue; metaboloic waste cause itching and uremic frost (crystallized deposits of urea on the skin)

Urnialysis shows fixed specificgravity approximately 1.010 equivalent to plasma; abnormal proteins, blood, cells adn casts are present.

# Laboratory tests indicate :-

BUN & Creatinine are elevated

Decreased creatinine clearance

Abnormal electrolyte values

Moderate Anemia; decreased platelets; decreased renal size positive renal biopsy if damage from cancer

# Priority Nursing Diagnosis for ESRD :-

Imparied tissue perfusion; renal; imbalanced nutrition: lesst hen body requirements; Risk for infection; Disturbed body image; Excess fluid volume; Activity intolerance

# Nursing Interventions :-

diet low in protein with supplemented amino acids, retrict fluids as ordered; provide electrolyte replacement or restriction: sodium & Potassium restriction

Replace bicarbonate stores to treat acidosis

Replace Calcium

Monitor of hypertension and heart failure

Prepare for kidney dialysis or transplant

Administer meds carefully d/t inability to excrete properly. Monitor intake and output & v/s, monitor labs, BUN, serum creatinine, pH, electrolytes & CBC. Provide symptom relief for N/V; watch for signs of infection, provide rest periods,

Med thearpy, limited by pts inability to excrete in kidney's. diuretics to reduce volume of extracellular fluid; ACE inhibitors to maintain normal blood pressure, electrolyte replacement phosphate binding agents; kayexalate to reduce potassium levles, folic acid, iron supplement & epoetin alfa (epogen) for anemia and multivitamins.