Case Study Haemodialysis Patient.

9447 words - 38 pages

IntroductionThe focus of this assignment is to analyse the care given to a patient on haemodialysis. It will attempt to explore the physical, psychological and social needs and to identify whether the care delivered met the individual needs of the patient.The Nursing Midwifery Council (NMC) Code of Conduct cites that nurses should "protect all confidential information concerning patients obtained in the course of professional practices and make disclosure only with consent". To adhere to this ruling, the pseudonym "Gloria" is used to identify the patient in this study.Patients Biography and Medical HistoryI have chosen Gloria as the focus of my assignment because, as her Named Nurse, it is my responsibility to assess her care needs. She presented with various medical problems, such as diabetes, anaemia, hypertension and anxiety over her sexual function with an altered body image due to the formation of her Arterio-Venous Fistula.Gloria is a 28-year-old single lady, who lives with her family. She gave up her studies due to haemodialysis treatment, resulting in feelings of isolation, loneliness and depression. Gloria's mother is very supportive and also copes remarkably well with two disabled daughters. Gloria is 53.5 kgs, 5'5 inches tall, thin, pale and tires easily due to her anaemia. Before commencing haemodialysis in September 2002 her haemoglobin was 9.9 g/dl. Gloria has been an insulin dependent diabetic since 1980 and has developed end stage renal failure as a result of diabetic nephropathy. She was diagnosed with retinopathy in 1990 and has undergone laser treatment in 1991.Apart from uncontrolled blood sugars, Gloria has rarely been unwell. In December 2001, she consulted her General Practitioner with occasional vomiting and shortness of breath upon exertion and bipedal leg oedema. On examination it was discovered that her blood pressure had risen from 140/85 mmHg to 150/90 mmHg. Normal blood pressure is 120/80 mmHg (www.detecting-hypertension.com). Urine testing showed proteinuria (+3) and blood sampling showed a gradual increase in creatinine from 686 umol/L to 783 umol/L. Gloria was commenced on Frusemide 80 PO mg daily. Her local General Practitioner had referred Gloria to the Nephrology Team. She attended the Renal Clinic who discovered that there was a deterioration in her kidney function and that Renal Replacement Therapy would be required. Regular hospital appointments and the general effect of her treatment interfered with her studies in the University.Gloria attended both the Nephrology and Pre-Dialysis Clinic where she was informed about the various treatment modalities. Dialysis in the form of Haemodialysis and Continuous Ambulatory Peritoneal Dialysis were the treatment options open to Gloria. She decided that haemodialysis would be the best treatment option for her.An Arterio-venous fistula was formed last June 2002. Gloria's blood was monitored monthly and her serum creatinine had risen from 408 to 701 mmol/l. A referral to...

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