Cisplatin Nephrotoxicity

In the role of a supplementary prescriber I could review him weekly and gradually increase his dose in line with the CMP dose schedule, his symptoms and tolerance. BNF (2014) additionally supports this by recommending the need for a re-assessment including physical health checks when a patient has reached a certain dose before titrating

liver and kidneys. Normal adult dose of some medications can be toxic to an older patient.

However, there are additional guidelines in terms of assessing the patient for prolonged catheter use. There should be frequent assessment and evaluation of the patient’s need for continued use. It is important to note that in addition to determining the patient’s need for catheterization, prior to insertion the nurse should also complete the following:

1. As the clinic nurse, what routine information would you want to obtain from S.R.?

Comprehensive assessments is the most valuable piece which allows Nurse Practitioners to know about the health risks, strengths and needs of their patients. Furthermore, the comprehensive assessment strengths the relationship between the Nurse Practitioners and their patients. From clinician-patients relationship, it helps a complete assessment to answer patients questions which in the long run help to achieve measurable goals and provide quality outcomes to the patients. Nurse Practitioners use comprehensive assessment approach to analyze, interpret, implement and follow up care to ensure their patients receive appropriate care and prevent inappropriate diagnosis. Comprehensive assessment is where the patients are encourage to

The dosage was to high for the patient because the chart started going over the regular normal level

And at the center of the care. Medication that has been given to the individual has to also be reviews as it may have reached its time limit this means that they might become immune to it like some antibiotics people can become immune to so that this drug will not be affective. Checks have to be done to make sure that the medication is still effective and is working correctly and the patient isn’t suffering any side effects. If there are side effects occurring or the individual has become immune to their medication there will be investigations in to which alternative medication can be given to them that won’t react the same. Scans and x-rays may need to be repeated by the people that have put together the care strategy this is done so that if anything has changed that the individual Is getting care for or physic then this can be assessed again if they need this level of care and it can be changed, or on the other hand if the case has gotten worse and they symptoms are worsening then this also can be looked at and things can be done so that the individual is receiving the right care.

Prior to discontinuing the IV Pitocin (oxytocin), which assessment is most important for the nurse to obtain?

In this Assessment nursing course, one of the major things that is taught is the most important part of giving proper care to a patient. Correct patient assessment is needed before any nursing care plan or treatment can be implemented. This post-review of a person’s assessment will demonstrate the proper way to go about assessing a person’s health.

* Monitor fluid and electrolyte status. Disturbances can have an adverse effect on ICP. Closely monitor IV fluids with the use of an accurate intravenous infusion

Another assess that the nurse should undertake is elimination. Bowl movements should be documented, as things may have changed since the handover from A&E took place. Mr C has experienced some confusion, the nurse should also ask if has had difficulty urinating, pain or burning. Collecting a mid-stream urine (MSU) may also be an idea to check for urinary tract infections (UTI’s).

Comprehensive assessments are fundamental in high acuity nursing as it allows nurses to establish a baseline for the patient, determine oxygen supply and demand, provide individualized patient care, and make clinical decisions (House-Kokan, 2012). The components of a comprehensive assessment, including a physical assessment, corroborative diagnostic data, and the family issues will be assessed (House-Kokan, 2012).

Assessment is described as”The first stage of the nursing process, in which data about the patient’s health status is collected” (Oxford dictionary of nursing, 2003, p23), following this phase a care plan can be devised.

Perform a urinalysis when possible to find levels of Specific Gravity (how concentrated the urine is), pH, Protein, Blood, Nitrites, Leukocytes, Ketones, Glucose and Bilirubin. The results of this test can help identify any possible impairment in renal function and identify the presence of an infection (Vera, 2011).

While patients are taking Captopril nurses should check if they are taking any other antihypertensive. Beta-blockers and diuretics can be used with captopril to help it reach its effect better. Many patients that are taking Captopril may experience neutropenia and should take precautions. “About half of the neutropenic patients developed systemic or oral cavity infections or other features of the syndrome of agranulocytosis” (Capoten, 2014). If captopril is going to be used in patients with impaired renal function, a white blood cell count should be done before beginning treatment and at approximately two-week intervals for about three months. Karch (2014) states physical consideration for nurses include, “skin color, lesions: T: orientation, reflexes,