Personal Impact: Living with Chronic End-Stage Renal Disease NUR427
October 3, 2011
Personal Impact: Living with Chronic End-Stage Renal Disease The Chronic disease I chose is chronic end-stage renal disease. End-stage renal disease is when there is a permanent loss of total renal function. End-stage renal disease, is also known as chronic kidney disease (CKD), with five stages. The fifth stage is the most severe stage, this is when the patient needs to begin dialysis, or be transplanted to survive. The Center for Disease Prevention and Control ranks End stage renal disease the ninth leading cause of death in the United States ("Center For Disease Control And Prevention", 2010). New cases of ESRD in African Americans is 3.7 times greater than the rate of Caucasians (Wells, 2011). Conditions that can be contributing factors in loss of renal function are: Diabetes, Hypertension, Glomerulonephritis, Cystic Kidney, and a list of others. Signs and symptoms of kidney failure are: decreased amount of urine, edema, shortness of breath, nausea and vomiting, poor appetite, metallic taste in the mouth, hiccups, weight loss or weight gain with fluid, fatigue, confusion or mental slowness, leg cramps and itching. These symptoms can present together or by themselves. Anyone can develop kidney failure due to a number of reasons. The people more at risk for developing kidney disease are older people, African-Americans, those who have a family history of CKD especially polycystic disease, Latinos and American Indians especially with type 2 diabetes. As of 2008 there were more than 550,000 patients receiving renal replacement therapy, coined RRT. The types of renal replacement include, hemodialysis, peritoneal dialysis, home hemodialysis, and transplantation. The cost of ESRD programs in 2008 was approximately 39.46 billion dollars annually, and has grown every year since. Patient Interview
Debra Jones is a 53 year old, African-American female, who has been on dialysis for six months. She is currently dialyzing at a free-standing dialysis unit 5 miles from her mother's home. Prior to being diagnosis with end-stage renal disease, Ms. Jones was a practicing LPN for 25 years. Six months ago Ms. Jones noticed some changes in here body, and since she was an LPN she stated she was more aware of these changes. Her symptoms were weight loss, with generalized edema, fatigue, and increased blood pressure. Since she was currently employed she had access to a primary care physician, she schedule a visit. During her first visit the physician ran some blood test, completed a history and physical and scheduled an ultrasound of her kidney. She was then schedule for a follow-up appointment to discuss the results of her test within a month. Review of test results, revealed she had lab values that indicated that she needed to see a nephrologists. Her physician increase her anti hypertensive medication, and referred her to a specialist. Ms Jones' appointment was scheduled within the same month. Within two weeks, Ms Jones was told she needed to start hemodialysis. She was scheduled to have a subclavian catheter placed so she could begin her treatment. First day of dialysis Ms Jones' was given a tour of the facility and then spent time with a Social Worker, Dietician and a nurse. She was instructed on her dialysis schedule, given a list of foods she could and could not eat, fluid restrictions, and emergency preparedness information that included what to do if she could not get to the facility for dialysis and how to take herself off of the dialysis machine in the event of fire or any other natural disaster. She was also given a host of papers to read and sign. Ms Jones, stated she felt very overwhelmed by all of the information she was given on the first day. She felt ashamed because she had been in nursing so long and was not aware of all the details surrounding kidney dialysis, so she asked very few questions initially....
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