The support needs of the participant
My participant, S suffering from chronic kidney disease needs support in medical, social, emotional, physical, and psychological aspects to manage her condition. As a patient with CKD, in accordance to the information provided during the interview, she experiences emotional and mental difficulties usually in the form of stress, depression, poor life quality and decreased confidence in herself. The needs can be generally unrecognized, neglected or under-prioritized by the healthcare providers. Though S is well informed about her condition, she still needs access to more information to enable her to make decisions on a care plan that will help her effectively manage her health. Her healthcare personnel should offer disease-specific details such as information on how the available treatment options and how dialysis can be delayed (Agodoa et al., 2017).
Since S agrees that CKD is treatable depending on the stage which one is at, she needs support to receive timely preparation for CKD therapy to minimize complications and progression of the disease. S should be referred to a skilled team for clinical and psychological development and support before the start of dialysis treatment. Assistance is needed in the management of medications. The participant, S should be assisted in understanding the different prescriptions to manage the disease. She needs full support while dealing with the resultant side effects of the medication, be made fully aware of consequences of failing to take drugs and the need to take medicines on time using the appropriate instructions issued (Agodoa et al., 2017).
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A diagnosis with CKD requires the support of friends and family. S mentioned her frustration from her husband due to her condition. There is a need for the healthcare team to offer support to by counseling her husband as her caregiver. He should be trained to recognize and effectively responding to symptoms, this includes noticing signs and knowing what to do when they occur and how to avoid worsening the symptoms (Agodoa et al., 2017). S mentioned her non-involvement in community activities and her reluctance to join social groups. She said that she sparsely attends church but is not a spiritual person. An excellent way to find emotional support is by encouraging her to seek social help by engaging support groups in the community, attending meetings to share experiences and information for mutual exchange. Social support has the positive effect on depression and anxiety.
Support to continue engaging and maintaining social and occupational roles is advisable for S since she is committed to what she does dealing with children and families affected by CKD. Provision of encouragement to continue working and sustain her hobbies and not concentrate on her condition. She also needs to maintain her relationships with family, performing her roles and any other in church or community at large. S requires a lot of support in her in modifying lifestyle and adapt to the new environment, discipline to adhere to strict dietary and fluid intake guidelines and positive behavior and respond to the disease. Support in developing and sustaining a positive attitude in mental and physical care to help in her to make decisions and eliminate anxiety and depression. It’s also highly recommended that she maintains a positive relationship with caregivers and the healthcare team for consultations and continued assistance.
How to implement the objectives of Healthy People 2020 to increase wellness.
Healthy people, 2020 main objectives are to reduce the number of citizens with kidney diseases. To implement the objectives, maintenance, and prevention of the major causes that trigger the condition chronic kidney diseases needs to be applied. Since diabetes is a common cause, there is a need to encourage its prevention and management. The reduction of infection objective can be achieved through the Diabetes Prevention Program which helps citizens pursue health options through moderate exercising, healthier diets, and weight management. Many volunteer organizations have been set up to reduce the risk of diabetes and promote healthy lifestyles in communities through initiatives, community programs and provisions of guidelines (Centers for disease control and prevention & National center for health statistics, 2012).
Implementation of the elimination of the disparity among kidney disease patient objective, healthy people 2020 has introduced behavior modification programs to educate the most affected community on how to avoid genetic transmission. The disparity is fuelled by the considerable influence of genetic determinants in the development and progression of CKD which affects populations differently. Teaching them to modify lifestyle belief’s cultures and practices have helped to reduce genetic transmission of CKD and to eliminate the disparities in the populations affected (Centers for disease control and prevention & National center for health statistics, 2012).
To implement the objectives healthy 2020 in collaboration with CDC introduced chronic kidney disease initiative healthy 2020 ensures for the implementation of the public health strategies which promotes kidney health. Their main aim is to raise awareness for prevention and control of risks factors and encourage early diagnosis which will improve the outcomes and patients quality of life for those living with CKD. The initiative has come up with different cost-effective screening treatment for anemic people with CKD (Centers for disease control and prevention & National center for health statistics, 2012).
Appropriate nursing interventions in chronic kidney and end-stage renal failure disease
When a person is diagnosed with CKD, it becomes necessary for appropriate interventions to be put in place to ensure smooth transition and treatment of the patient. Significant interventions are carried out by professional caregivers including doctors, nurses and their skilled healthcare team assigned to take care of the patient (Hoeman, 2007). A nurse makes several interventions to prevent progression and improve the conditions of a patient with CKD.
Nutritional therapy- a nurse will conduct a dietary intervention which includes a careful analysis and regulation of proteins, fluids, and sodium intake. The nurse will intervene through constant evaluation of fluid status. Continuous assessment is necessary to identify potential causes of imbalances and take the required measures including regulated intake to balance the loss of fluid. Proper diet changes which are to be strictly adhered to must be made to control the risk of CKD.
The nurse must ensure appropriate nutrition status for the patient which is consistent with the treatment. Promotion of intake of proteins especially the high biologic value protein foods such as meats, eggs, and dairy products. The nurse is involved in altering the patient's schedule for better placement of medication schedule such that medicines are not taken immediately before meals for effective treatment. Supportive therapy offered through encouragement is a professional intervention mainly carried out by nurses (Homan, 2007). Nurses promote positive feeling by encouraging the patients to be independent and educating them on proper self- care. They also support the patient to engage in activities and exercises which are alternated with rest.
The nurse also carries out interventions through education of self-care advising the patient on the problems that need medical attention to be reported to the medical team such as changes in standard urine output, nausea, vomiting, and diarrhea ammonia odor on breath, abdominal cramps, clotted fistula, and other signs which might indicate infections (Hoeman, 2007).. The nurse is tasked with explaining and stressing the need for follow up to manage the patient physical changes, evaluation of renal function and dialysis. It is also upon the nurse to conduct home referrals after assessing the patient home environment and the coping strategies adopted by the patient and family. Nursing interventions are considered productive and successful if a patient maintains an ideal body weight without fluids, has adequate nutritional intake, participates in the tolerated activities and the patient's self-esteem is improve during and after treatment.
References
Agodoa, L. Y. C., Garcia-Garcia, G., & Norris, K. C. (2017). Chronic kidney disease in disadvantaged populations. London: Academic Press.
Centers for disease control and prevention (Etats-Unis), & National center for health statistics (Etats-Unis). (2012). Healthy people 2010: Final review. Washington (D.C.: Government printing Office.
Hoeman, S. P. (2007). Rehabilitation nursing: Prevention, intervention, and outcomes . St. Louis, Mo: Elsevier Mosby.
