Chronic kidney disease, commonly referred to as chronic kidney failure, describes the gradual loss of kidney functions. Typically, kidneys filter wastes and excess fluids from the blood which are later excreted as urine. When CKD reaches an advanced stage, electrolytes, excess fluids and wastes accumulate in the body and reach toxic levels. Medical experts and health care providers contend that chronic kidney disease may not become apparent until kidney functions are significantly impaired. CKD is one of the leading health concerns in the United States (Taylor, 2014). Additionally, chronic kidney failure has subjected millions of American citizens to live in poverty since they have to a significant percentage of their incomes on treatment and drugs.
Chronic kidney disease is usually the very last stage of progressive loss of kidney functions. The loss is typically slow and gradual with no symptoms. A sufferer only notices the signs when the kidneys are about to seize functioning. This usually culminates in renal diseases during which kidneys are entirely unable to eliminate toxic wastes from the body. To cope with the situation and improve his or her quality of life, a patient must undergo kidney transplant or sign up for dialysis treatment which is often very expensive. Care and effective treatment of CKD patients accounts for approximately 20% of annual Medicare expenditure in the United States. Indeed, governments all over the world have had to increase its healthcare allocation to meet the overwhelming demand. Moreover, the risk of progress and death have in the recent years been linked to excess alcohol consumption and smoking among kidney patients (Taylor, 2014) .
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The number of Americans affected CKD has in the recent years reached a historic high. Medical experts argue that the number is bound to increase if the concerned authorities do not act prudently to avert the alarming crisis. According to available statistics, 30 million Americans have chronic kidney disease. Globally, approximately 200 million people have CKD. African Americans have a four-fold excess risk of chronic kidney disease compared to their White and Hispanic counterparts (Taylor, 2014). Furthermore, developing nations of Africa, Asia, and South America have the highest rates of chronic kidney disease Annually, more than half a million people develop CKD stage five in African, and a significant majority of the patients suffer premature mortality.
The healthcare cost and economic burden of chronic kidney disease are incredibly high and not manageable even in advanced nations. In patients with CKD, interrelated comorbidities with shared risk factors including hypertension, diabetes, lipid disorders among others can potentially aggravate renal and cardiovascular outcomes. According to doctors, a vast majority of people with CKD are likely to develop one or more comorbidities. I medicine, comorbidity is the presence of one or more additional illness or disorder co-occurring simultaneously with a primary disease or disorder (Vera, 2014). Comorbidity also suggests interactions between the disease that potentially worsen the course of both.
In my quest to gain more insights on Chronic Kidney failure, I reached to 50 KCD patients and requested them to take part in my study. 20 of the participants were African Americans aged between 35 to 65 years. Fifteen of the participants aged between 30 to 60 were Hispanics while the rest were White. The sample was large to avoid biases. Half of the participants were from middle and lower class families while the rest were from the upper class and upper middle class. The sample composed of individuals from all the races to determine if the race is a contributing factor to KCD.
Healthy People 2020
The primary goal of Healthy People 2020 is to significantly reduce new cases and related deaths, economic burden on Americans with chronic kidney disease. CKD impacts millions of Americans either directly or indirectly. On matters CKD, Healthy People 2020 intends to reduce the percentage of Americans with kidney disease, increase awareness among patients, increase access to dialysis and access to kidney transplant among other things. Meeting the Healthy People 2020 objectives for chronic kidney disease to has the potential to prolong the lives of and improve the quality of life of individuals with CKD. Additionally, the initiative hopes to reduce the burden associated with CKD and eliminate disparities among kidney disease patients. This, therefore, implies that all Americans will have access to kidney treatment irrespective of their social or economic position (James B. Wetmore, 2016) .
Nursing Diagnosis
The nursing goals for patients with CKD is to prevent advanced complications and provide supportive care. It is also critical to educate patients and their caregivers on how best to manage the condition (Vera, 2014) . The nursing diagnosis that is common in individuals with CKD includes impaired skin integrity, imbalanced nutrition, decreased cardiovascular output, adverse fluid, and electrolyte imbalances. The ineffective breathing pattern is also common among patients with chronic kidney disease.
Assessment Data
Subjective Data
Two of the participants reported that they were unable to pass urine for at least three days. They also stated that the few numbers of times they managed to pass urine the urine appeared to be very dark brown. They also indicated that they experienced a burning sensation when passing urine.
Objective Data
Two of the participants aged 40 and 36 years with renal failure condition were examined, and the following results were obtained; their lab results indicated a high percentage of potassium. Additionally, one of the patients had excess body fluids.
Nursing Interventions
Fluid Excesses
The renal disorder usually impairs glomerular filtration that leads to fluid overload. The drastic increase in fluid volume leads to increased hydrostatic pressure thus compelling excess fluid into the interstitial spaces. Because the venous end cannot reabsorb the excess fluids, fluid capacity overloads the nymph system and remains in the interstitial spaces resulting in edema, extreme weight gain, pulmonary congestion.
Assessment
The patient manifest the following symptoms; edema, weight gain, oliguria, changed thought process among others.
Diagnosis
Excess fluid volume significantly decreases glomerular filtration and sodium filtration. The patient should be encouraged to adopt behavior that enables him or her monitor his/her fluid status and reduce recurrence of fluid.
Acute Pain
Most CKD patients experience excruciating pain. This usually results due to trauma caused to the kidney.
Assessment
The patient may exhibit the following; general body weakness, facial grimaces, irregular sleeping patterns and flank pain. The diagnosis of this particular condition is usually an acute pain.
Planning
To alleviate pain, it is critical to train the patient in various relaxation techniques. Additionally, caregivers should be educated on how to respond to patients promptly.
Altered Renal Tissue Perfusion
For body cells to function, the kidneys must eliminate harmful substances such as Urea and uric acid from the body. Individuals with KCD usually have impaired kidneys hence are vulnerable to the accumulation of toxic products in the body tissues. Symptoms for this condition include hypertension, edema, and anuria.
Planning
The patient is encouraged to change his/her lifestyle to prevent further complications. Secondly, the patient will demonstrate participation in the recommended program. During this stage, it is crucial to establish rapport with the patient to get his/her corporation.
Strategies for Families and Caregivers
Besides doctors and medical experts, family members and caregivers have a role to play when dealing with a KCD patient. For example, they can motivate the patient to air his/her concerns verbally. This enables the patients to deal with their fears and change their thought process. Secondly, they should continuously emphasize to the patient the need to adhere to the recommended diet. Adhering to the prescribed diet can help prevent aggravation of illness.
References
James B. Wetmore, A. J. (2016, August 30). NCBI . Retrieved from NCBI: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5220656/
Taylor, R. (2014, December 12). Nursing in Practise . Retrieved from Nursing in Practise: https://www.nursinginpractice.com/article/chronic-kidney-disease-management
Vera, M. (2014, March 10). Nurselabs . Retrieved from Nurselabs: https://nurseslabs.com/6-chronic-renal-failure-nursing-care-plans/
