Question

PLEASE READ THE CASE STUDY AND ANSWER THE QUESTIONS TO THE BEST OF YOUR ABILITY:

Mr. Jackson is 86 years old. He is admitted to HUMC for congested heart failure. He also has a history of renal failure and goes for dialysis on Mondays, Wednesdays and Friday. He has an AV fistula in his right hand. He also has a history of diabetes, hypertension and depression.

He is allergic to shrimp. He is a nonsmoker. He lives with his wife and two sons.

He is on a renal, low sodium, low cholesterol diet.

He is positive for clostridium difficile.

He suffered a stroke while he was in the hospital and now has left sided weakness.

8. What types of complications do you think Mr. Jackson might be at risk for and give the reason why he would be at risk?

Answer 1

Complications of congestive heart failure:-

1. Kidney damage or failure
Heart failure can reduce the blood flow to your kidneys, which can eventually cause kidney failure if left untreated. Kidney damage from heart failure can require dialysis for treatment.

2. Heart valve problems
The valves of your heart, which keep blood flowing in the proper direction through your heart, may not function properly if your heart is enlarged or if the pressure in your heart is very high due to heart failure.

3. Liver damage
Heart failure can lead to a buildup of fluid that puts too much pressure on the liver. This fluid backup can lead to scarring, which makes it more difficult for your liver to function properly.

Complications of chronic renal failure-

1. Heart disease can cause kidney disease, but kidney disease can also cause heart disease. Heart disease is the most common cause of death among people on dialysis.
When kidneys are not working well, they cannot support the other parts of body as they should. This can cause problems with heart.

2. Bone disease and high phosphorus (hyperphosphatemia)

Patient need calcium and vitamin D to have healthy bones. Healthy kidneys help keep bones healthy. If client have CKD, then kidneys may not be able to do this important job.

3. Metabolic acidosis

Metabolic acidosis is a buildup of acid in body. kidneys help keep the right balance of acids in body. Metabolic acidosis is common in people with kidney disease because their kidneys are not filtering their blood well enough.

Complications- If diabetes on worst level.

Nerve damage (neuropathy)
Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish nerves, especially in legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.

Kidney damage (nephropathy)
The kidneys contain millions of tiny blood vessel clusters (glomeruli) that filter waste from blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.

Eye damage (retinopathy)
Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.

Complications of C. difficile infections include:

1. Dehydration
Severe diarrhea can lead to a significant loss of fluids and electrolytes. This makes it difficult for your body to function normally and can cause blood pressure to drop to dangerously low levels.

2. Kidney failure
In some cases, dehydration can occur so quickly that kidney function rapidly deteriorates (kidney failure).

3. Toxic megacolon
In this rare condition, your colon is unable to expel gas and stool, causing it to become greatly distended (megacolon). Left untreated, your colon may rupture, causing bacteria from the colon to enter your abdominal cavity. An enlarged or ruptured colon requires emergency surgery and may be fatal.

4. A hole in your large intestine (bowel perforation)
This is rare and results from extensive damage to the lining of your large intestine or after toxic megacolon. A perforated bowel can spill bacteria from the intestine into your abdominal cavity, leading to a life-threatening infection (peritonitis).

5. Death
Even mild to moderate C. difficile infections can quickly progress to fatal disease if not treated promptly.

Complications of left sided weakness-

Social Cognition Unable to multitask.
Disorder in executive functioning.
Disharmonic intelligence profile
Lack of overview and structure
Language and Speech problems Aphasia Dysarthria
Apraxia
Hyperacusis
Lack of empathy.