Hypotension Essay

Ms. Mancinho continues to strive for excellence and patient care improvements in her position as staff nurse in the hemodialysis unit. She is currently the primary nurse for five of our chronic dialysis patients. All of her primary patients exceed recommended adequacy guidelines and maintain patent, infection free arterial venous fistulas/grafts. While participating in monthly interdisciplinary care plan meetings, she makes suggestions that have led to positive outcomes such as: changes in dry weights, reviews of patients medications with the nephrologist to facilitate warranted medication adjustments as needed, referrals/close coordination with other disciplines such as podiatry and wound care to prevent infection/amputation in patients with advanced vascular disease, and endocrinology for educational purposes for well controlled blood sugars. She is able to quickly assess subtle changes in her patients to then notify the charge nurse and physician for appropriate guidance in facilitating positive patient care outcomes. Through her acute assessment skills she prevented an access from clotting. Prevention of clotting leads to extended longevity of the access. She applies the nursing process to systems or processes at the team/unit/work group level to improve Veteran care. She worked with flow in the new unit which led to better patient care and staff satisfaction. She developed the time out policy: a requirement for

1. Postural vital signs. It is important to test for orthostatic hypotension especially given the patient's recent change in medications

(Marieb and Hoehn, 2010, p 703) defined Blood Pressure (BP) as ‘the force per unit area exerted on a vessel wall by the contained blood, and is expressed in millimetres of mercury (mm Hg)’. BP is still one of the essential and widely used assessment tools in healthcare settings. Nurses generally record the arterial BP which is the forced exerted blood that flows through the arteries, to establish a baseline and to determine any risk factors. BP

The concern regarding the use of anti-hypertensive medication as a treatment procedure for hypertension has mainly been centered on the optimal choice of these agents. The other factors include the side effects of these drugs on a hypertensive patient, especially coughing. While three categories of these drugs are linked with cough as a side effect, they have varying casual explanations though angiotensin-converting enzyme (ACE) inhibitors play a crucial role (Van Amburgh, 2011). The main objective for the use of anti-hypertensives in dialysis patients is to obtain and sustain an optimal blood pressure or lessen it by the least intrusive measures possible. While this is not

There were no significant differences between either of these labs or the blood volume processed before or after Ateplase push or dwell administration (Vercaigne, Zacharias, & Bernstein, 2012). Push administration injects a small amount of Ateplase into circulation, while the dwell method doesn’t. Often time patient catheters are dwelled with Ateplase in between treatments, as the dwell method requires at least two hours (Vercaigne, Zacharias, & Bernstein, 2012). Hemodialysis units operate on a stringent schedule per shift that decreases flexibility of time. As a result of this the push method is most widely ordered. Within this author’s clinic, once the push method is unsuccessful after two attempts the dwell method is then implemented. In conclusion, the push method was found to have the best immediate and long term results within this study. The authors identified that the sample size was inadequate, which ultimately decreased the validity of this finding (Vercaigne, Zacharias, &

What supports the diagnosis of chronic renal failure instead of acute renal failure? Give reasons from George’s history; his signs/symptoms.

Deficient fluid volume happens when there is a significant loss of fluid and electrolytes as with excessive sweating. Dehydration can occur from an insufficient fluid intake, excessive fluid loss, and fluid shifts. The first sign of dehydration is thirst. If the patient would have drunk water when he first became thirsty, him collapsing may not have occurred, and no further treatment may not have been needed. If fluids continue to be lost, the heart pumps faster but is rapid and weak and causes orthostatic hypotension, explaining his pulse being 136 and blood pressure being 88/52. Orthostatic hypotension may have caused him to collapse due to the

If you have diabetes along with kidney disease, additional steps may be necessary to slow any more damage to the kidneys. High blood pressure and obstruction of any ducts can also alter treatment. It is crucial to work out a treatment plan with your physician. Dietitians will assist in creating a specific diet plan with the right amount of sodium, protein and fluids and also help regulate blood pressure and any sort of insulin issues that may be present. Dietitians will also help encourage and push you to live, or start living a more healthy lifestyle which will not only ease the pain, but also increase your overall health. Dialysis also has a lot to do with dietitians. According to Laura L. Ellingson, author of The Performance of Dialysis Care: Routinization and Adaptation on the Floor, dialysis treats people with kidney failure by using machines to filter the blood, removing excess fluid and waste materials. Dialysis treatment is life sustaining, but is also a demanding, often exhausting process accompanied by strict monitoring of diet, fluid intake, and other lifestyle factors (p 2). If you are exercising, and eating clean, REAL food, this process is more bearable. Whereas if you eat junk food before going to dialyze, it is very painful due to all of

I think that this is normal for me because I have a lot of muscle on my lower body due to performing heavy compound movements at the gym such as squats and deadlifts.

Prerenal failure is one of the most developed causes of kidney failure in patients who are hospitalized. Most conditions, such as burns, long-term vomiting, bleeding, dehydration results in a decrease amount of blood flow to the kidney. Due to blockage or tightening of blood vessel carrying blood to the glomerular filtration rate, this may complicate fluid and electrolytes and result in excess fluid volume. According to Best Practice & Research (2007), “it may lead to ischemic tubular necrosis when the reduction in blood flow is sufficient to result in the death of tubular cells.” However, without sufficient fixation to prerenal failure, it may result in the next stage of intrarenal acute kidney failure.

In Kidney failure cases urea, creatine, uric acids and electrolytes move from the blood to the dialysate with the net effect of lowering their concentration in the blood. RBC s WBC s and plasma proteins are too large to diffuse through the pores of the membrane. Hemodialysis patient are exposed to 120 to 130 L of water during each dialysis treatment. Small molecular weight substances can pass from the dialysate in to patient’s blood. So the purity of water used for dialysis is monitored and controlled.

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).

The hypotension is a condition in which the blood pressure is much lower than the values considered being normal. Blood pressure varies from person to person. In general it is considered hypotension a condition in which the maximum pressure (or systolic) is equal to or lower than 90 mmHg and the minimum (or diastolic) is equal to or less than 60 mmHg. The hypotension causes are multiple and different significance: therefore vary from a trivial dehydration to more serious disorders. Low pressure is a disorder that can affect any person regardless of age.

Fluid restrictions vary depending on physicians and the patient’s individual scenario. The restrictions typically are between 1,000 and 1,500 mL a day of fluid. “A fluid allowance for patients is calculated on an individual basis depending on urine output and dialysis settings. It is vital to follow your nephrologist/nutritionists fluid intake guidelines” (Orange, 2016). It is important with what the physician orders to make sure the patient follows it strictly and doesn’t go over the allowed amount in the twenty four hours. “People on dialysis often have decreased urine output, so increased fluid in the body can put unnecessary pressure on the person’s heart and lungs” (Orange, 2016). I would have to check the order for this patient to be

An increase in high blood pressure is noted to affect renal functions negatively. Hypertensive renal disease is just one of the disease that can result due to high blood pressure. Hypertensive renal disease is a disease that is characterized by hypertension which is associated with renal dysfunction (Perneger et al,1995). The disease is primary manifested by an increase in the level of serum creatinine (Udani, Lazich & Bakris,2011).The persistent increase in the level of serum creatinine is a reflection of a substantial amount of renal parenchymal damage as an irreversible of kidney dysfunction to some extent. The increase of Mr.Issler's BUN and Creatinine results are the main biomarkers that led to the positive diagnosis of hypertensive renal disease .The nurse plays an essential role in the provision of care for