Chronic Kidney Disease Medical Assignment Help
The management of patients with chronic kidney diseases are complex and requires continuing assessment, planning, intervention, and patient education (Neyhart et al. 2010). Mrs Delane’s chronic kidney disease has progress to stage 4. Stage 4 is a severe renal impairment stage where interventions and future treatment plan need to be decided. From this stage the kidney fails to excrete the waste products and toxins (uraemia) from the body and as a result of uraemia accumulation the patients will generally feel very sick with signs and symptoms like lethargy, oedema, anxiety and depression, extreme weakness and fatigue, headache and anorexia. Mrs Delane’s physical condition should be assessed and she must be provided health education on the progression of her disease with focus on further treatment and management needs. She should be referred to a nephrologist as she will need to decide on renal replacement therapy and begin preparation for dialysis or kidney transplant. Meanwhile she should be put on diet and fluid restriction.
Mrs Delane is suffering from severe renal failure and as result she needs to consider future treatment options. Some of the issues that need to be identified to assist her make decisions are supportive care, self-care and body image. The first support she will need is the renal supportive care services. Renal support care services provides outpatients clinics and inpatients care by coordinating referrals to other specialties like dialysis unit, palliative care, social support, and hospital admissions apart from patient consultation and symptom management (Josland et al. 2012). Another supportive care she will need would be palliative care support if she decides not to have renal replacement therapy. The aim of the palliative care is to reduce the distress and discomfort of the patients and to make the transition from active care to palliative care smoother (Josland et al. 2012). Other supportive care like community health care services, spiritual support groups and end of life care support including bereavement support should be explained to help her make decision about her future treatment. As she is a widow, self-care is an important consideration for managing her chronic illness. Self-care involves living healthy lifestyles to meet individual’s social, emotional and psychological needs and to care for their chronic conditions to control disease progression or accident (Kennedy, Rogers & Bower 2007). It is important for Mrs Delane to understand that she will have to adhere to management plans and treatment regimens and make necessary adaptation to lifestyle to meet the progressing limitations imposed by her chronic condition. For instance if she decides for renal transplant, it will be very convenient for her to manage her immune suppressive medication rather than depending on others as she will have to be on those medication throughout the rest of her life. The issue of body image needs to be identified for her as people undergoing dialysis will have problems dealing with body image issues. Body image is a mental representation or schema of one’s own body and unsuccessful adaptation will lead to physical and psychiatric symptoms such as anxiety, depression, psychogenic pain and cognitive distortions (Livneh & Antonak 2005). Chronic kidney diseases are specially linked with body image issues as renal replacement therapy involves carrying access catheters for dialysis and scar, weight gain and excess body hair growth due to immunosuppression therapy in renal transplant (Muringai et al. 2008).
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