Superior Essay Writers | Nursing care of a patient with acute on chronic renal failure

Shift handover:

Identify: Mr David Smith, HRN: 123456, DOB: 26/03/1948

Situation: David is a 72 year old Caucasian man from Wellington. He has been admitted to the CDU medical ward with Acute Kidney Injury (AKI) secondary to Pyelonephritis. He has a 1/52 history of fever, fatigue, decreased urine output, increased urgency and R) flank pain. He has now been transferred to the CDU Medical ward for continuing care.

Background: David is a widower and lives in Wellington. He lives alone in a single story home but his daughter lives close by and helps out when needed. He is independent with his cares. He has an extensive past medical history including: T2DM, Ex-smoker (quit 5 years ago), HTN, Hyperlipidaemia, chronic kidney disease stage 3 (Baseline eGFR 40 ml/min/1.73m2), chronic venous leg ulcer to L) leg, anxiety. No known declared allergies (NKDA). He is obese (BMI 30) and drinks 1 bottle of wine every night.

Assessment: Airway: Own, patent Breathing: RR 22, Sats 94% on RA. Circulation: HR 96 bpm, BP 160/95 mmHg, Bilateral pitting oedema to his calves. Disability: GCS 15/15, 2/10 pain to R) flank, feels tired and a bit worried. Exposure: Temp 38.4 oC David looks unwell. He is restless and has a flushed appearance. His urine is dark in colour and offensive smelling. He has urinated 100 ml into a urine bottle since admission to hospital 4 hours ago. David had 2 x IVC’s inserted to both ACF’s and is tolerating a diabetic diet. He last opened his bowels this morning.
Pathology (on admission)
WBC — 15.0 x 109/L (4.0-11.0)
urea — 14 mmol/L (3.0-8.0)
serum creatinine — 213 µmol/L (60-100)
eGFR — 25 mL/min/1.73 m2 (90-120)

Recommendations/Read back:
Medical orders
• Routine ward assessment and observations
• Strict fluid monitoring
• MSU for MC & S
• Diabetic diet and fluids as tolerated
• Pain management
• TED stockings and DVT prophylaxis
Medication orders
• Intravenous sodium chloride 1000mls over 8 hours
• Intravenous frusemide 80mg STAT
• Oral paracetamol 1g QID, S/C morphine 2.5mg, 4 hourly PRN
• Usual medications: Metformin XR 1gm BD, Ramipril 10mg OD, Simvastatin 20mg OD
Nursing orders
• Devise a plan of care for your patient

Assessment Tasks:
Using the template attached to complete this Assessment and, based on the handover you received at the beginning of your shift today, other information included below and current reliable evidence for practice, address the following tasks.
Do not make up or assume information in relation to or about David. Only use what you know from the information you received today.

Task 1: Assessment
Based on the case scenario and in grammatically correct sentences identify:

• Three (3) priority nursing assessments you would conduct at the commencement of your shift
AND

For each assessment you have identified explain:

• Why it is necessary for David’s condition and nursing care?
• What consequences can occur if this assessment is not completed accurately?
• What chart or document could you use to assist with/record your assessments?
(Approximately 350 words)

Task 2:

Based solely on the handover you have received and using the template provided, complete a nursing care plan for David. Your plan must address the physical, functional and psychosocial aspects of care.

Five (5) nursing problems have been provided for you. For each nursing problem on your care plan you need to identify;

• What it is related to?
• Goal of care
• Interventions
• Rationales for interventions
• Evaluation

Notes for Task 2 only
• Dot points may be used in the care plan template
• Appropriate professional language must be used – legally recognised abbreviations may be used in this task (care plan) but a KEY with full terminology must be provided after the assignment references – key will be excluded from word count tally
• Rationales must be appropriately referenced
(Approximately 1000 words)

Task 3: Patient education

Discharge planning
An important aspect of nursing practice is to effectively and succinctly communicate relevant information related to ongoing disease management or prevention of reinfection or deterioration on discharge.

Patient education and discharge planning starts on admission and you need to provide David with education during your shift in preparation for discharge home.
• Explain two (2) important points/topics you will need to include in David’s preparation for discharge to aid healing and prevent further illness.
For each education point identified provide:
• One (1) strategy to assist David to implement the education into his daily routine.
(Approximately 350 words)

Task 4: Documentation

An important legal requirement of nursing practice is to effectively and succinctly document relevant information, actions and outcomes related to patient care and provide an accurate reflection of the health status of the patient, their responses to care and the patient’s perspective.
• Make an entry into David’s patient progress notes documenting the successful implementation of your nursing care plan.

You can choose any progress note format but your documentation must:
 Demonstrate person-centred care
 Adhere to the legal and professional standards for documentation
 Appropriate professional language must be used – legally recognised abbreviations may be used in this task but a KEY with full terminology must be provided after the assignment references – key will be excluded from word count tally

Sample Solution

find the cost of your paper

 

“Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!”


Superior Essay Writers | Nursing care of a patient with acute on chronic renal failure was first posted on August 24, 2019 at 2:55 pm.
©2019 "Graduate Paper Help". Use of this feed is for personal non-commercial use only. If you are not reading this article in your feed reader, then the site is guilty of copyright infringement. Please contact me at support@cheapcustomwriters.com

"Is this question part of your assignment? We Can Help!"

Essay Writing Service