After a series of discussions with the Manager of the dialysis unit I was able to convince her to submit the proposed policy for CVC maintenance and dressing change in hemodialysis patients. The policy is developed with assistance from the manager of the dialysis unit. The guidelines were obtained from a preexisting document but modified to the hospital’s protocol Provide a copy of the documented protocol, algorithm, or…
simplifying transcendence. It’s sad, stressful seeing health from the patient’s perspective or presupposition beyond death, but nurses allow a patient to advocate and help guide them to desired outcomes. An 85-year-old woman has been a patient in hemodialysis facility since 2012.…
According to Schouten et al (2008), sepsis involves the activation of the coagulation cascade coupled with down-regulation of anticoagulation and fibrinolysis. An intricate link between inflammation and coagulation exists within the body (Neligan, 2006). When a pathogen is present in the bloodstream or when tissue injury occurs, an inflammatory response occurs. The response causes a stimulation of the immune system to produce interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis…
(Finkelstein et al, 2012). Participants are enrolled in the cohort for 3 years with a minimum of an 18 month follow-up. Cohort members were required to be adult patients with ESRD who were considered suitable candidates for special prescription of daily hemodialysis via the NxStage System One device (Finkelstein et al, 2012). Participants were all also required to have Medicare as their primary insurance payer for administrative reasons. The control group to this study consisted of 5,000…
An End Stage Renal Disease (ESRD) patient in her 30’s has sickle-cell anemia. She has only dialyzed intermittently as an out-patient for a total of a month since admission almost three months ago. She has been hospitalized numerous times in that short duration. The dialysis clinic operates within a certain guideline that prompts movement from having the least recommended dialysis access to one that is considered the most effective and efficient. The patient has a central line as an access. The…
Anemia can be a sign of systemic illness. Because it is never normal, the cause for it should be sought when it is present in the patient. Is a common finding in a family practice office that is sometimes straightforward in nature, but perplexing at other times. There are numerous processes that can result in anemia. You can result from decreased production of red blood cells which is seen in nutrient deficiencies such as low B12 levels and iron levels, bone marrow disorders, suppression of…
potentially caused by large proteins not easily filtered by the kidneys. These proteins could be a result of multiple myeloma cancer (plasma cell Ca). The appropriate tests had been taken; results had not returned. In the meantime, she required hemodialysis. I learned about tempory dialysis access catheters. There was a system created using a chest tube that’s name was not clear to me. Perhaps, tunneled cath dialysis? That had been misplaced, punctured the lung or pleural area causing a…
needs to follow a strict renal diet. A renal diet is low in potassium, phosphorus, and many other electrolytes. A patient may need to restrict fluid intake also. To sustain a longer life once the kidneys have failed many patients have to have hemodialysis. This process cleans the blood by filtering out the toxins. Another form of dialysis that may be performed is peritoneal. Peritoneal goes through the line of the abdomen. However, dialysis will not cure it can only prolong…
measurement of its level has been used as a useful tool in the diagnosis of Pneumocystis pneumonia, or at least in the screening for the disease. However, it must be noted that false-positive results can arise due to certain factors such as bacteremia, hemodialysis, certain antimicrobial drugs and the administration of immunoglobulin. In addition, the cut-off value that can be used in the diagnosis of Pneumocystis pneumonia still needs to be determined. Krebs von den Lungen-6 (abbreviated as…
“Nursing-sensitive outcomes are defined as changes in health status upon which nursing care has had a direct influence, “according to Yang, Ke-Ping A., Simms, Lillian M., Yin, Jeo-Chen T. This is when a patient’s health status changes due to the current treatment or healthcare delivery and fulfillment. Some of the factors that may contribute to Nursing-sensitive patient outcomes include the following bio-psychosocial functioning and patient satisfaction. Two examples of nursing-sensitive patient…