Question

SCENARIO:

Mrs. A, 53-years-old with a 17-year history of type 2 diabetes, hypertension and hyperlipidemia and a 35-year history of smoking. She presents in the ward with shortness of breath, pruritus, and pitting edema of bilateral extremities. Her blood pressure is 165/92 mm Hg, heart rate 94 beats per minute (regular rate and rhythm), and respiration 26 breaths per minute. She is 153cm tall and weighs 91kg (BMI: 38.9).

Mrs. A is diagnosed with stage 3 chronic kidney disease, with a GFR of 49 mL/min/1.73m² and profound microalbuminuria.

QUESTION:

Based on the the above scenario, organize relevant nursing care and management for Mrs. A in order to maximise her overall health and delay the progression of end stage renal disease (ESRD).

requirement rubrics:??

Organize relevant nursing care and management for Mrs. A in order to maximise her overall health and delay the progression of end stage renal disease (ESRD)

ineed full explanation about this. tq ??

Answer 1

Mrs A is diabetic for 17 yrs

Hypertensive

Hyperlipidemic

Having bilateral edema

Shortness of breath

Stage 3 CKD

Mrs A is obese tooo.

BP 165/92

BREATHS PER MINUTE 26BPM

HR94/MIN

BMI 38.9

GFR 49ml/min 1.73m2 .

There is a strong possibility for CKD to progress into ESRD.

Proper management and nursing care will help to prevent complications and fast progression to ESRD.

The goal of management and care is to maintain kidney function and homeostasis as long as possible.

Mrs A requires astute nursing care to avoid the complications of reduced renal function and anxieties of a life threatening illness.

Before giving care a proper assessment should be done and that include

1 assess fluid status

2 assess dietary patterns and nutritional status

3 assessong family responce of the patient

4 assess understanding of the disease condition,treatment and its consequences

5 assesing all the other parameters related to patients health.

From the assessment we can organize proper nursing care .

The care should be directed towards

1 maintenence of ideal body weight.

2 maintenance of adequate nutritional intake.implement a dietary programe to ensure proper nutritional intake within the limits of treatment regimen.

3 maintenance of fluid volume to maintain homoeostasis.assess fluid status and identify potential sources of imbalance.

4 participation in activity.promote positive feelings by encouraging increased self care and greater independance.

5 help to improve self esteem.

6 prevent complications

7 Medications.proper attention shpuld be given to patients medication timings.and if any difficulty in it ,it should be informed with doctor in time.

8support adjustment to lifestyle changes

9 monitoring of the bloodpressur,heart rate,respiratory rate,GFR at proper interval.

10 proper rest should be there provided alternating activity with rest.

11 proper attention towards comorbidities of the patient should be given.

12 proper hygiens should be maintained and encouraged the patient about the maintenance of hygiene.