question archive DIAGNOSIS LIST: Chronic renal failure with dialysis via av fistula Diabetes Type II Dementia (MMSE 19/30) Peripheral edema Chronic ulcers lower extremities Hypertension MEDICATION LIST: Zofran prn Sliding scale Humalog prior to meals Lantus 10units bid Namenda 10mg qd Renavite qd Lasix 40mg bid BACKGROUND INFORMATION: Patient is a 68 year old, Hispanic, female
DIAGNOSIS LIST: Chronic renal failure with dialysis via av fistula Diabetes Type II Dementia (MMSE 19/30) Peripheral edema Chronic ulcers lower extremities Hypertension MEDICATION LIST: Zofran prn Sliding scale Humalog prior to meals Lantus 10units bid Namenda 10mg qd Renavite qd Lasix 40mg bid BACKGROUND INFORMATION: Patient is a 68 year old, Hispanic, female
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DIAGNOSIS LIST:
- Chronic renal failure with dialysis via av fistula
- Diabetes Type II
- Dementia (MMSE 19/30)
- Peripheral edema
- Chronic ulcers lower extremities
- Hypertension
MEDICATION LIST:
- Zofran prn
- Sliding scale Humalog prior to meals
- Lantus 10units bid
- Namenda 10mg qd
- Renavite qd
- Lasix 40mg bid
BACKGROUND INFORMATION:
Patient is a 68 year old, Hispanic, female. Speaks primarily Spanish, knows only broken English. She has been a dialysis patient for over 10 years. Most recently it has been more difficult for dialysis to maintain proper fluid status post dialysis. She has also been experiencing severe nausea upon return which affects her eating habits for the day. She has been sent out to the hospital from the nursing home where she lives three times in the last month upon return from dialysis due to being unresponsive, hypotensive, and once for hypoglycemia. She has had a progressive decline in mobility and at this time does not even like to get out of bed, sleeping most of the day. Today upon return from dialysis it was noted that the nephrologist is recommending a discontinuation of dialysis treatments. Her daughter is very involved in her care and visits daily. Labs: CBG range: 34-280 prior to meals, k+ 2.8, BUN 58, creat 1.8. She remains a full code at this time.
Paragraph form #1:
Complete research on the role of the nurse in this case. Provide the findings of your research: educational requirements of this role, complete job description, their specific role in patient-centered care (Holistic Care).
Paragraph form #2:
Include a paragraph on the role of the patient's NURSE, followed by the initial presentation of the plan of care (include assessment data, Goals/Outcomes, Interventions, Rationale, Evaluation & replanning process), questions for two other interprofessional team members: PCP, Social Worker, Dietitian and family from the perspective of the NURSE. These questions are case-specific for social, legal, ethical, or economic elements that need addressed. Two questions posed to team (one for each of two other roles above) clearly asking a question to improve the inter-professional team collaborative effort. You are presenting the plan from the perspective of the nurse, but in the paragraph, it should be clear that you know the roles of others and that you know how to utilize the members of the team for the best outcomes for your patient.
Think critically about this patient's situation and all parties that should be involved from the mindset of the role of the nurse. Please look at this holistically and patient-centered, within the role of the nurse. Present questions to the other interprofessional team members and present interventions, support, actions, suggestions, ideas, etc. to the team. Are there other disciplines that should be involved in this case? How can this team proceed to optimize positive patient outcomes?
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Group Case Study
Part One (paragraph 1)
Healthcare providers should assess and intervene in patients with various health complications. Nurses have a significant impact in care facilities by helping doctors carry individual care plans and treatment administration. Besides, nurses communicate with patients, understand the need for holistic and patient-centered care through a compassionate and empathetic treatment process. Nurses working with a nephrologist on patients diagnosed with dialysis should practice utmost patient-centered care with a professional code of conduct. The registered nurses in hemodialysis got the duty of checking the patient's vital signs. Healthcare providers have the responsibility of talking with patients with multiple health complications to assess the recovery process. Besides, the education requirement for such nurses is the attainment of a bachelor's degree in nursing for license qualifications (Study.com, 2021). Kidney diseases require expertise to treat patients with chronic ailments. The neurologist nurse also evaluates the patient's reaction to dialysis treatments and medications. Such medical prescriptions require certified and licensed nurses.
The case study highlights Martha Gutierrez having several illnesses, including renal failure, diabetes II, and hypertension. Holistic care is essential in the provision of in-depth care in understanding patient care. According to Florence Nightingale, the principle of holistic care was based on the humanistic view and unity of the patient (Jasemi, 2017). The diagnostic of dementia is a chronic persistent disorder instigated by brain disease with memory illnesses and impaired reasoning. A holistic care advocate for neurologist nurses to provide psychological counseling to the patients. The patient requires frequent counseling services and changes in sleeping patterns. Also, holistic care got significant when addressing the client's diabetes type II through monitoring the patient's food intake. The patient should avoid sugar-sweetened foods and beverages such as soft drinks and high-fat meat. Peripheral edema involves swelling of hands or lower legs. Neurologists should provide guidelines for physical activities such as raising affected limb higher than the heart and through diuretics.
Part Two (paragraph 2)
The American Nurses Association (ANA) emphasized the nurse's responsibility as a patient advocate. Nurses should comply with professional guidelines for patient satisfaction. They should ensure the patients get guaranteed individual autonomy (Gerber, 2018). As per the case study, the neurologist's nurses should explain the current health complications to the patients. Besides, identification of the illness contributes to the patient's medical preferences and choices. The patient has the right to choose suitable interventions based on social and cultural perspectives. The patient should get informed on the reasons for discontinuation of dialysis despite the renal failure. The patient requires psychotherapy, physical activity, and a good diet to prevent further health complications based on the assessment data. The lifestyle factor should also get considered. The patient requires utmost care and family interactions to avoid the possibility of developing depressions that would worsen health conditions. According to the analysis, the client got few chances of living due to the unresponsive nature to dialysis.
The outcome from patients' health complications and discontinued from dialysis results in mortality in most cases. Stopping patients from having dialysis leads to the build-up of toxins in the patients' blood. The toxins would result in health conditions referred to as Uremia, which can get addressed through medications. Stopping dialysis has brought outcomes and consequences such as death within one to several weeks, depending upon the condition of the kidney left. Dialysis gets terminated after various reasons got examined by healthcare providers. Long-term conditions that worsen without the likelihood of improvement lead to possible dialysis terminations to help reduce issues with low blood pressure and unbearable living conditions. However, healthcare providers such as physicians and social workers must get consulted in the continuum of care to have practical team-based care (Flinter et al., 2017). Why should the patient get informed of the consequences after the termination of dialysis? How long is the patient expected to stay after the end of dialysis? And the possible solutions and interventions that would prevent death after dialysis termination. Healthcare providers should assess the patients' health conditions and communicate to the respective family members of the health status of the patients after dialysis failure.
Outline for Group Case study
- First Paragraph
Part one (paragraph
- Healthcare providers should assess and intervene in patients with various health complications.
- Nurses communicate with the patient
- Nurses practice utmost patient-centered care with a professional code of conduct.
- The registered nurses in hemodialysis got the duty of checking the patient's vital signs.
- Nurses should talk with patients with multiple health complications.
- Second Paragraph
- The case study highlights Martha Gutierrez having several illnesses.
- Holistic care is essential in the provision of in-depth care in understanding patient care.
- The diagnostic of dementia is a chronic persistent disorder instigated by brain disease.
- A holistic care advocate for neurologist nurses to provide psychological counseling to the patients.
- Neurologists should provide guidelines for physical activities such as raising affected limbs.
- Third Paragraph
Part Two (paragraph 2)
- Nurses should comply with professional guidelines for patient satisfaction.
- Identification of the illness contributes to the patient's medical preferences
- The patient should get informed on the reasons for discontinuation of dialysis
- The patient requires psychotherapy
- According to the analysis, the client got few chances of living due to the unresponsive nature to dialysis.
- Fourth Paragraph
- Discontinuing patients from having dialysis leads to the build-up of toxins in the patients' blood
- Ending dialysis has brought outcomes and consequences such as death within one to several weeks
- Healthcare providers such as physicians and social workers must get consulted in the continuum of care
- Healthcare providers should assess the patients' health conditions and communicate to the respective family members
