SupportNeed Analysis for a 45-year Old Man Diagnosed with Kidney Disease
SupportNeed Analysis for a 45-year Old Man Diagnosed with Kidney Disease
The45-year-old patient known as AML was diagnosed with kidney diseasewhose existence was brought about by an existing diabetic condition.Due to the kidney disease, the patient needs different levels ofsupport. The disease has a high impact on the life of both thepatient and the people around him but through care from the medicalprofessions and the family members, the condition can be controlledleading to assuagement of suffering and a prolonged life.
Boththe patient and the family members need support in accepting theresults of diagnosis. AML and the family were shocked by the outcomeof the results, which indicated that AML was suffering from kidneydisease. Due to such a situation, AML and his family requirepsychological counseling as suggested by Pagels et al. (2015), toprevent the development of conditions that might arise due todistress. Psychological counseling is appropriate as it makes thepatient accept his condition, and follow the instructions offered bythe healthcare practitioner. It is the nurse’s duty to provideholistic care to alleviate the patient’s emotional distress, andhelp them manage their condition.
Thenurse should also help the patient, and the family to cope with thesituation. To ensure that this is effective, the nurse should explainthe outcomes of the diagnosis to the patient and the family. He orshe should also be ready to answer any questions, or giveclarifications regarding the patient’s condition. He or she shouldalso ensure that the patient undergoes regular check-ups after afixed duration to make sure that all the parameters are normal. Thefamily should be advised to be close to the patient to as to make himcomfortable.
Thepatient also requires treatment as a form of support for hiscondition. Diabetes Kidney Disease comes with various complicationsthat may affect the functioning of the kidney, and could also resultin renal failure. Kidney failure is a fatal stage but through propermanagement, such can be evaded, or its onset prolonged. It isimportant for the nurse to ensure that the patient’s blood pressureis kept on the check and that proper measures are taken to regulateit. ACE inhibitors such as Lisinopril and angiotensin II receptorantagonists (AIIRAs) such as losartan are necessary drugs in theregulation of blood pressure. The two types of drugs are essential asthey also help to protect the kidney from further damage in additionto controlling the blood pressure (Fried et al., 2013). The drugsalso lower the risk of cardiovascular events, which might arise dueto adverse effects of kidney disease and high blood pressure.Prevention of hypertension or its management prevents the risk ofdeveloping cardiovascular diseases such as stroke and heart attack,which are the leading causes of death for individuals suffering fromkidney disease as suggested by Levey & Coresh (2012).
Thepatient should undergo dialysis. Kidney disease compromises thefunctioning of the kidney leading to a buildup of fluid in the body.Such occurs when the kidney functions below 10% of its averagecapacity (Levey & Coresh, 2012). The stage of dialysis can bearrived at after failure of diuretics.
AMLshould be guided on the proper diet that fits his condition. Thepatient’s family, the nurse, and the patient himself should ensurethat his diet has very little amounts of proteins. A reduction inprotein intake delays the onset of kidney failure and reduces therisk of macroalbuminuria (Levey & Coresh, 2012). The patient,however, needs proteins and the drugs that function as phosphatebinders can compensate for such. Such drugs include Sevelamer andAlucaps these are useful especially in situations where diet fails.The other support measure to be taken is to ensure that the patientsticks to the daily doses of insulin. This helps to control hisglucose levels and reduce the deleterious effects that hyperglycemiamight have on the nephrons.
Roleof the Nurse in Management of the Condition
Nursesplay a pivotal role in the management of patients with diabetickidney disease. One of the major roles is to ensure that the patientaccepts the diagnosis, and agrees to manage the condition. It isafter acceptance that other support processes will be fruitful.
Thenurse should educate the patient on the importance of controllingblood pressure levels. By educating the patient, they will be able tounderstand that maintenance of blood pressure levels within thestandard range is a critical step in preventing the progression ofkidney disease. It is also appropriate for the nurse to educate thepatient on maintenance of blood glucose levels, and to ensure thatthey take the insulin doses in the right manner (Pagels et al.,2015). Control of blood glucose levels slows the progression ofkidney disease. Finally, the nurse should advise AML and his familyon healthy eating and exercise as a way of managing the patient’scondition, and also help the other relatives from developing thesame.
Implementationof the HealthyPeople 2020Objectives to Increase Wellness
Reductionof deaths of individuals with the end-stage renal disease is one ofthe goals of HealthyPeople 2020.According to TheHealthy People 2020,Diabetic Kidney Disease is the prominent cause of premature deathsand one of the major contributors to high medical costs in the UnitedStates of America (Levey & Coresh, 2012). Some of the primaryobjectives stated in the document include a reduction of the kidneydisease burden, and to ensure that the patients with the conditionlive a longer life. To implement this, proper care will be offered tothe patient to ensure the condition does not progress to fatal stageor lead to the development of other tragic conditions such ascardiovascular complications. This will be offered through givingproper medication, and regulating other conditions such ashypertension, which may be consequential of diabetic kidney disease.The nurse will also ensure that there is proper dialysis equipment atthe health facility to enable the patient access the serviceswhenever needed.
Kidneydisease compromises the kidney’s ability to regulate fluid volume,and to conduct its excretion function, which can be fatal. HealthyPeople 2020provides that all patients with kidney disease should be able toaccess dialysis services whenever needed, thus making it anobligation of the nurse to provide the same. The nurse will alsoensure that the patient’s serum creatinine, lipids, andmacroalbuminuria are strictly checked through laboratory analysis asprovided for by the HealthyPeople 2020.In the case of kidney failure or complete destruction of the kidneys,the patient should receive a kidney transplant (Levey & Coresh,2012). The implementation of this objective will aid in increasingthe patient’s wellness, and protect the patient from fatalitiesthat are preventable.
Pagels,A., Hylander, B., & Alvarsson, M. (2015). A Multi-DimensionalSupport Program for Patients with Diabetic Kidney Disease. Journalof Renal Care,41(3),187-194. doi:10.1111/jorc.12114
Fried,L. F., Emanuele, N., Zhang, J. H., Brophy, M., Conner, T. A.,Duckworth, W …& Reilly, R. F. (2013). Combined angiotensininhibition for the treatment of diabetic nephropathy. NewEngland Journal of Medicine,369(20),1892-1903.
Levey,A. S., & Coresh, J. (2012). Chronic kidney disease. TheLancet,379(9811),165-180.