Protein injection for dialysis patients

Illness and Disease Management CKD Interview

Betsy Quinones

February 27, 2021

NSG4055- Illness And Disease Management across a Lifespan

Professor Amber Mccall

Illness and Disease Management CKD Interview

Introduction

Mr. X has a medical diagnosis of stage 3 chronic kidney disease. According to the interview, he has a little bit of an understanding of his condition, though his level of awareness is low. He pointed out that the condition has changed his relationship with family and friends. The quality of life of individuals is closely related to the quality of life of those around them (Golics, 2019). In this journal, Golics further went and published that most chronic illnesses have the same impact on the family. In this case, chronic kidney disease has disrupted the psychological, emotional, and normal functioning of the family and some friends of Mr. X. Even the study advocates for a family-centered approach to care the disruptions brought about by the disease process negatively affect the wellbeing of the patient.

According to the stages of grief, Mr. X is at the level of acceptance same to the family. This stage means the patient has understood and accepted what the condition means to his life. The family members and friends have also reached the acceptance stage and are with him in his hard moments. Acceptance is not necessarily an uplifting stage of grief, it may mean that there may be more good days than bad but there may be still bad – and that is ok (Holland, 2018).

Coping mechanisms

Dealing with chronic illnesses requires coping skills to avoid sinking into depression. As for Mr. X, the main coping skill is lowering expectations of the awaited outcome. For example, if his blood has been taken for waste analysis before dialysis when the results come, he has trained himself not to expect much to avoid disappointments if otherwise. In addition to lower expectations, Mr. X also asks for help if need be, especially financial support. Change of source of stress and distance from the source of help has also been practiced by Mr. X to cope with stress. Finally, maintaining emotional composure has also been deployed by the patient to avoid stress (Coping skills and strategies, 2017).

Treatment of CKD

The treatment for Mr. X is partly symptomatic and largely therapeutic. For example, on occasions where the hemoglobin levels are low, he is given ferrous sulfate tablets or iron injections to control anemia. Diuretics such as furosemide are given to the patient to control edema. He is put on antihypertensive drugs to control his blood pressure which is the suspected root course of his condition. He also attends two sessions of hemodialysis each week to eliminate wastes from the blood (Medication, 2019).

Support aspects

The support aspect of chronic kidney disease is social, emotional, and psychological. The patient requires family and friends to offer social and emotional support to provide the patient with strength and the will to take treatment accordingly. Given that the condition comes with a lot of stressors, psychological support by a trained psychologist would be necessary to ensure the mental health of the patient is in good condition.

In conclusion, the following information will be necessary indirect development of a care plan for a group of patients with chronic kidney disease because the disease process is similar and that the complications of the condition are the same and may only vary from patient to patient. The treatment of complications with vitamin D and antihypertensive will be the same across board and dialysis too (Section 10: The role of social, cultural, psychological, and family relationship factors in the etiology of disease and illness, 2018).

References

Fishbane, S., & Spinowitz, B. (2018). Update on anemia in ESRD and earlier stages of CKD: core curriculum 2018. American Journal of Kidney Diseases, 71(3), 423-435.

Golics, C. J., Basra, M. K. A., Finlay, A. Y., & Salek, S. (2013). The impact of the disease on family members: a critical aspect of medical care. Journal of the Royal Society of Medicine, 106(10), 399-407.

Holland, K. (2018, September 25). What You Should Know About the Stages of Grief. Healthline. https://www.healthline.com/health/stages-of-grief

Medication. (2019). Kidney Care UK. https://www.kidneycareuk.org/about-kidney-health/treatments/medication/

Section 10: The role of social, cultural, psychological, and family relationship factors in the etiology of disease and illness. (2018, February 21). Health Knowledge. https://www.healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-economics/4a-concepts-health-illness/section7/activity4/answers

Stressors: Coping Skills and Strategies. (2017). Cleveland Clinic. https://my.clevelandclinic.org/health/articles/6392-stress-coping-with-lifes-stressors

Zhang, L., Zhang, P., Wang, F., Zuo, L., Zhou, Y., Shi, Y., ... & Wang, H. (2018). Prevalence and factors associated with CKD: a population study from Beijing. American Journal of Kidney Diseases, 51(3), 373-384.

Appendix

1. Does the patient have a family history of cardiovascular disease or diabetes?

Yes, cardiovascular disease from the father of Mr. X.

2. What is the patient’s level of awareness about CKD?

Low level.

3. What is the degree of kidney damage, and are there any complications that have been developed?

Stage 3B moderate CKD, complications are anemia, gout, and fluid buildup.

4. When did the patient start experiencing symptoms?

2 years before diagnosis.

5. Does the patient have hypertension or postural changes?

Yes.

6. Does the patient experience any chest pain? If yes, what are the location, nature of radiation, and severity?

Chest pains and discomfort are usually felt on the left side, the pain is moderate.

7. What does the laboratory result reveal about the patient’s fluid and electrolyte balance?

GFR 30-59

8. Is the patient undergoing dialysis? If yes, then for how long?

Yes, twice per week

9. What is/are the possible cause of the patient’s CKD?

Hypertension

10. Which type of treatments or drugs is the patient receiving currently, and what is the response?

High blood pressure medications, medications to treat anemia, medication to relieve swelling, medication to lower cholesterol, and a low protein diet.

11. Are the patient’s caregivers adequately aware of the evidence-based management practices of CKD?

Yes.

12. What are the results obtained from evaluating heart sounds, peripheral pulses, vascular congestion, capillary refill, and temperature measurement?

Temp 37 C, capillary refill of 4seconds, a peripheral pulse of 85bpm,

13. What is the level of the patient’s activity intolerance?

Insufficient physiological energy to complete required daily activities.

14. What is the level of pain experienced by the patient?

Moderate pain.