Question

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Mr. Chevez is a 77-year-old Caucasian male who has a long history of diabetes and hypertension.

1,What members of the interprofessional team may be included in Mr. Chevev care?

His primary care provider monitored him for the past year as Mr. Chevez’s kidney function and overall health gradually decreased. His wife has cared for him in their home until last month when he fell and she was unable to lift him. During a discussion with her daughter, Mrs. Chevez agreed that her husband required more care than she was able to provide. He was then admitted to an extended care facility. The physician who has been seeing Mr. Chevez in the facility notes that his glomerular filtration rate is 10 mL/min/1.73 m2.

2. What stage of kidney disease is Mr. Chevez in?

Mr. Chevez is noted to have an accumulation of fluid in the abdomen, loss of muscle strength, and hypoxemia.

3.Would Mr. Chevez qualify for a kidney transplant? Why or why not?

Mr. Chevez’s wife provides the extended care facility with advance directives signed by Mr. Chevez one year ago. This document indicates that he does not wish to prolong his life with extraordinary intervention. The nurse, who is aware of Mr. Chevez’s advance directives, has asked the nursing assistant to change linens for all patients this morning. Upon entering Mr. Chevez’s room, the nursing assistant notes that he is not breathing. The nursing assistant rushes back to the nurse and states, “we have to call a code!”

4.What actions should the nurse take?

Answer 1

1 . Interprofessional team should be consist of --

A) primary health care provider -- the family or general physician, nurse practitioner.

B) pharmacist  

C) Registered nurse

D) Endocrinologist ( doctors have a detailed knowledge on endocrine system as in diabetes the problem is seen in pancreas)

E) Cardiologist ( doctor have detailed knowledge in cardiovascular system as hypertension is present)

F) Nephrologist. ( doctor have detailed knowledge in kidney as hypertension can be due to kidney problems)

G) ophthalmologist. ( doctor have detailed knowledge in eye ..as diabetes can spread to eye and leads to diabetic retinopathy)

H) Podiatrist

I) Registered dietitian. ( as there should be presence of strict diet to counter diabetes)

J) mental health professional or psychologist or psychiatrist

K) fitness professional.

2.  Mr. Chevez is in END STAGE OF KIDNEY OR ALSO KNOWN AS KIDNEY FAILURE.

He is in end stage kidney failure beacuse the GFR(glomerular filtration rate) is 10 mL/min/1.73m^{​​​​​​2}

The normal range of GFR remains from 90-120 mL/min/1.73 m²

3. YES, Mr.Chevez is qualified for kidney transplant . As he is in the end satge of kidney disease that is kidney failure. There is no scope of reviving the patient except kidney transplant or dialysis is done. Here is an indication is seen that accumulation of fluid in the abdomen,loss of muscle strength, hypoxemia.

4. This is an emergency. Nurse have to do immediate resuscitation efforts for that first check that whether he is breathing or not along with the pulse is present or not and also CPR certification. There may be cardiopulmonary arrest occured to the patient.

If the patient heart beat or pulse is present then immediately the patient should be transferred to ventilation or to extended care facilities.

If it is being justified after process like no pulse or other vital signs then the nurse should inform the family that the patient is dead.