Acute Renal Failure Patient Regarding Prevention

The population of interest in the proposed evidence-based project includes adults; (i) with a primary diagnosis of hypertension (values >140/90 mmHg or a mean daytime systolic BP of130 mm for diabetic patients), (ii) aged 18 years or over, and (iii) able to express themselves in written or spoken English. Patients with a diagnosis of end-stage renal disease, severe cognitive impairment or any other form of illness that would make their participation in the quality improvement

Situation: Two patients in their 70s present to the office at different times today, each with documented heart failure: one diastolic and the other systolic, and both are hypertensive. First, discuss the difference between systolic and diastolic heart failure, providing appropriate pathophysiology. ACEI/ARBs are the only medications prescribed for CHF that have been found to prolong life and improve the quality of that life. EXPLAIN the mechanism of action of ACEI/ARBs and how they affect morbidity and mortality in CHF. Be specific. Diuretics must be used very carefully in diastolic ventricular dysfunction. EXPLAIN this statement using appropriate physiology. Now considering all of the above, describe an appropriate comprehensive plan of

Chronic kidney disease (CKD) is a worldwide problem that is currently three times higher for African Americans, Hispanics, Pacific Islanders, American Indians and seniors (The National Kidney Foundation, 2013). CKD occurs when the kidneys are damaged by a pathogen or injury and they can no longer adequately maintain proper levels of regulated chemicals in the bloodstream. There are many risk associated with CKD. According to the National Kidney Foundation, two of the major risks are Chronic Renal Failure (CRF) and Cardiovascular Disease. Currently twenty million American adults have CKD and millions of others are at increased risk. Age has no barrier on getting CKD. People with pre-existing health issues, and a part of certain population

Varying patients may present to their clinician or the emergency department for treatment with heart failure. It is important to understand that there is more than one type of heart failure; primarily the focus is placed on diastolic heart failure and systolic heart failure. Depending upon the cause of heart failure and what areas are affected dictates the treatment plan needed. While there are similarities with both kinds of heart failure, there are also differences that can help the clinician distinguish the diagnosis needed to fit the patient. Once a diagnosis is made the clinician can move forward in determining if the patient is at risk for use of diuretics and then look towards prescribing ACEIs, ARBs, and beta-blockers.

Congestive heart failure (CHF) is a situation where the heart is not able to pump adequate blood to the other organs of the body. Causes of CHF are coronary artery disease, past myocardial infarction, hypertension, heart valve disease, cardiomyopathy, congenital heart defects, endocarditis and myocarditis (American heart association, 2013) .In the case scenario of Mr. P 76 year old man comes with the history of cardiomyopathy and CHF and in the past repeatedly admitted for the management of CHF symptoms. This essay discusses about approach to care, treatment plan, patient and family education and teaching plan that is given to Mr.P.

Enworom, C. D., & Tabi, M. (2015). Evaluation of Kidney Desiase Education On Clinical Outcomes and Knowledge of Self-Management Behaviors of Patients with Chronic Kidney Disease. Neprology Nursing Journal, 363-373.

Pharmacological treatments with diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers or aldosterone antagonist, and beta-blockers are essential for the treatment of heart failure and are effective in improving symptoms of heart failure and patient well-being. Diuretics are administered to help get rid of the excess fluid that helps improve breathing associated with shortness of breath, at rest or on exertion. Diuretics provide relief from symptoms and signs of pulmonary and venous congestion by promotion of fluid loss through the kidneys. Diuretics, for example, Furosemide helps improve breathing status, but monitoring patients for dehydration and kidney problems is crucial. Patient education is essential to ensuring medication adherence and early identification of adverse effects and potential for drug interactions.

During my Med-Surg clinical, I was assigned to a patient who was a 94 year female that had several medical conditions. The situation that ensued was difficulty communicating with her, since she did not speak English. Not only did the patient not speak English, but was only alert to herself, as well as extremely confused. As a result, being able to provide effective and quality care became a challenge. The reason for her admission was hyperkalemia, UTI, congestive heart failure (CHF) and acute renal failure (ARF). Unfortunately, the patient had other comorbidities that affected her well being such as diabetes mellitus, hypertension, atrial fibrillation, BPPV, CAD, s/p stent, DVT, CKD, stage 4 sacral decubitus ulcer, cholecystectomy, hip fracture and LE fasciotomy DVT.

There are many Chronic Renal Failure patients who are elderly and have additional diseases, such as diabetes, chronic pain, and others. Many of these patients have to wait as much as an hour to an hour and a half before and after treatments. The lack of policy and the absence of close management of this schedule may potentially put at risk patients in greater danger. Instead of patients being in the clinic

Strategies to educate in reference to the self-care needs of the congestive heart failure patient seems to be common theme in multiple literature reviews. The educational materials may be presented to the patient by the bedside nurse, physician, pharmacy technician, and the nurse or nurse practitioner who is involved with the patient post discharge. It is suggested by one article that the effective impatient measures should include medication review, one hour of heart failure education, adequate discharge planning and communication between the patient, and health care team (McClintock et al., 2014). Once discharge the article suggests that the effective measures include early follow-up, continued education and health management by clinics,

Almost every one in the United States knows a person suffering from congestive heart failure. This disease has manifested its way into the lives of so many—the statistics are astounding. According to the National Heart, Lung and Blood Institute, nearly 5 million people are affected and it is the main reason for hospital admission in older adults over the age of 65. This is a great cause for concern. In order to reduce the morbidity and control this epidemic, we must first understand the risks and causes of this condition. It is of the upmost importance to first understand the risks and causes of this condition. Education plays a key role in order to recognize the clinical manifestations and necessary actions to best treat

It is quite recognized in nursing that most heart failure patients do not take proper care of their heart failure once returning home from a stay at the hospital. They are reluctant to change their years of dietary and poor activity habits, and do not follow up with their physicians as they are directed to. Their desire to read all of the provided information is frowned upon as being too much, especially with the additional verbal information they receive from their doctors, nurses, and dieticians while in the hospital. It has been observed that the patient needs a simpler method of managing their heart failure at home. With this in mind, the goal of this project is to recognize that the patient is the primary stakeholder whom needs an easy to read and follow set of instructions that they will use to help them manage their heart failure throughout the day. A Heart Failure Quick Reference Tool (see Appendix A for heart failure tool steps) and nurse teaching materials were researched and developed, and a select number of nurses were educated. Though the information was well received by the patients and staff, the given amount of time available to

It is imperative for nurses to administer a full cardiac assessment of Congestive Heart Failure patients and work in collaboration with a team of health care providers from physicians, pharmacist, physical therapist, occupational therapist and other health care providers to educate Congestive Heart Failure patients and develop an effective care plan to avoid readmission. According to the article, effective communication and education will empower the patient to understand the disease which ultimately can help with self-management and decrease readmission. The patient will have constant communication with a team of multi-disciplinary health care providers that will create a comprehensive plan of care for the patient. Nicholson (2014), stated that health care

End-stage renal disease is a permanent damage to the kidneys leading to need for dialysis on regular basis to maintain life and its quality (End- stage renal disease, 2013). According to National kidney foundation (2013), the number of ESRD patients in United States which are under treatment are approximately 615,000, out of which 430, 000 are being treated with dialysis more than 185, 000 have successful renal transplant. The data also indicates that there has been 57 % increase in the number of patients diagnosed with renal failure. The rate of disease can be calculated on the basis of number of patients per one million general population and adjusted on the basis of age, gender and sex. In 2008, the data indicates that the adjusted rate of ESRD patients was 351 per million general population and the highest adjusted rate was detected in Ohio valley, Texas, California, and southwestern states (2010 Atlas of end- stage renal disease in United States).

In patients with heart failure, hypovolemia, cirrhosis, nephrotic syndrome, or hypoalbuminemia, renal function may be further compromised. BUN, creatinine clearance, and urine output should be monitored closely (Lexi-Comp, 2016).