Chronic Kidney Disease and Renal Anaemia - Essay Example

CHRONIC KIDNEY DISEASE AND RENAL ANAEMIA CHRONIC KIDNEY DISEASE AND RENAL ANAEMIA Introduction Clinical assessment is conducted from the scenario of Sola, who is suffering from stage 4 chronic kidney disease (CKD) and sickle cell disease (SCD). There are several results shown in relation to these conditions. There are measures put to the patient to enable her boost her immune system. The paper focuses on developing the measures of intervention for these conditions. There are also prevention measures and pathophysiology of these diseases. The findings as well as future practice recommendations have been underscored. Holistic Assessment of the Patient Due to the patient’s stage 4 chronic kidney disease, dialysis will assist to remove the toxic waste that may have accumulated in her blood. During dialysis process, Solas blood is removed by a dialysis machine, in small amounts, via a man-made membrane, referred to as a dialyzer. The dialyzer helps to clean some of the toxins that can no longer be removed by the kidneys. The blood that gets back to Sola is cleaner (Lapworth 2006). The patient should not take diets that would result in the production of toxins excreted through the kidney. However, the best treatment the patient should get from stage 4 Chronic Kidney disease is a kidney transplant as there are limited limitations in dietary intakes. In regard to Sickle cell anemia condition that Sola is suffering from, regular transfusion of blood is paramount to increase the carrying capacity of Oxygen hemoglobin. It also aids the patients blood to flow into the narrow vessels in all parts; offering Sola regular transfusion of the blood will help in the management of this condition. Application of chronic transfusion therapy will be essential in reducing the frequency of pain that Sola may be experiencing (Mahoney 2005). The health physicist should regularly give advice to Sola on how to manage the condition to ensure that she does no develop other complications. Hospitalization, being the most important initial action to take for pneumonia patients, Sola should ensure that regular medical checkups are done to prevent effects of the disease. Pneumonia is a very severe condition that may result to admission of the patient. Hospitalization would help harbor the effects of the illness from reaching levels that would pose a threat to Solas immunity. Being a patient with various implications that affect immunity, there is a great need for Sola to have regular medical checkups on these conditions. It will help to prevent worsening of her immune system (Flynn 2013). According to the assessment results, the patient has a very low level of hemoglobin in the blood and this impairs Oxygen transport. The level of Ferritin is higher as a result of regular transfusion of the blood. LTSAT is also far below the normal level, requiring solar to take necessary medical precautions. The percentage of hypochromic cells should be used by employment of necessary medical advice to boost the hemoglobin in the blood. Interventions and Proposed Management The best way that Solas stage 4 chronic kidney disease can be intervened is through continued dialysis in order to remove the toxins from the blood (Kan 2013). The dialysis prevents the body from being damaged by the toxins as the blood that gets back from the dialysis machine is cleaned up. It, therefore, has reduced amount of toxins that could rather not be excreted by the kidney. After dialysis, Sola should ensure there is regular medical checkup with nephrologists in order to prevent chronic failure of the kidney. It is important as Sola will have limited options of treatment. In order to ensure that dialysis works for her, she is restricted from certain types of diets and should also take the medications as the doctors prescription requires (Newman 2006). The patient should also show up for all treatments required. The dietary interventions for the patient include reduced intake of potassium in order to control the blood pressure, reduced intake of proteins and management of diabetes. The patient should also engage in nutritional management training programs to ensure proper dietary intake. Stage four chronic kidney diseases can be managed by targeting on new blood pressure and making recommendations of eGFR. The Management can also be done by making recommendations on albuminuria and enhancement of chronic kidney disease system of staging and color coded action plan (Weir 2010). Support resources for the patients should be put in place to counter the effects by patients who suffer from the conditions. There is a need to undertake an endorsement of early prevention and treatment of the conditions. Development of CKD and automatic reporting of glomerular filtration rate should be estimated. Health sector should develop a program for measuring the CKD and albuminuria or proteinuria in order to harbor the effects in the future. To undertake prevent sickle cell anemia, parents and children should be taught specific skills of physical assessment and the interventions in order to prevent pain episodes at home. Some of the treatment that should be administered to the patients while at home includes intake of fluids, taking of warm baths, rest, heating the pads and warming of the moist towels and quiet play. Parents should be encouraged to seek medical attentions with immediate effects if they notice serious problems in their children. The nurses should have adequate knowledge on precipitating factors for the sickle cell anemia crisis, the symptoms and signs of complications and the way that this condition can be resolved. Teachers should be made aware that persons with this condition should have a regular intake of water and other clear liquids, not to mention being allowed to rest regularly. In order to have proper care for children and other people with sickle cell anemia, it is important to give them simple tasks since their oxygen intake is often limited by the sickle celled red blood cells. Management of pain for the patients with sickle cell anemia should include four main stages, including assessment, treatment, reassessment and adjustment. In case of persistent paid, regular procedures should be followed in order to relieve the patient from suffering. The strategies of treatment for sickle cell anemia should aim at various goals, which include management of Vaso-occlusive crisis, management of chronic pain syndromes and management of chronic hemolytic anemia. Treatment and prevention of infections, detection and treatment of pulmonary hypertension and prevention of stroke should also be undertaken. Transplantation of Allogeneic bone marrow can cure sickle cell anemia, but the problem comes with the identification of the patients that can be given BMT. The risk-to-benefits associated with transplantation of BMT should be carefully assessed. Underlying Patho-Physiology In sickle cell condition, there is the assumption of sickle shape by the molecules of defective hemoglobin after their exposure to the low tension of Oxygen. The lodged red blood cells are unable to pass through the narrow blood vessels to the deeper tissues in the body. The patient may experience fever, swelling or pain if there is the occurrence of ischemia (Chaudry 2009). If there is exposure of erythrocyte in unlimited amount of Oxygen, the sickle cell may regain the normal shape. The main cause of CKD is hypertension, which results from an increase in the blood pressure due to deleterious effects. If high blood pressure lasts for a long time, the end results to the patient are high interglomerular pressure, which impairs filtration at the glomerular (Singh 2005). If there is impairment of glomeruli, filtration of proteins is increased resulting in high amount of protein in the urine, a condition referred to as microalbuminuria or proteinuria (Goldsmith 2009). High blood pressure results in damage of the blood vessels within the kidney, which impairs the ability of the kidney to filter the blood waste materials and other fluids, therefore resulting to increased volume of fluids in the blood (Greenberg 2009). The patient may finally develop chronic kidney diseases (Pipeline Review, H1 2012. (2012, March 22). Overview of Clinical Assessment From the clinical assessment done on the patient, the findings showed possibility of the patient having sickle cell anemia (SCD). The conclusions are made due to the presence of 5% hypochromic cells in the blood. The hypochromic cells are paler than normal, a sign that hemoglobin level in the red blood cells has reduced. Hemoglobin level in the blood of the patient is significantly below the normal level (Wailoo 2001), which is an indication that her hemoglobin is impaired. On the other hand, the findings from the assessment show that the patients’ Ferritin level is above the normal requirement in the body. It indicates that the patient is unable to excrete excess waste through the kidney. In addition, reduced LSAT to 15% in the body shows that the patient has kidney problems. In order to improve the patients conditions, dialysis and regular transfusion of blood are recommended on a regular basis, to reduce the level of sickle cells and toxins in her blood. Regular medical checkups are also advocated to ensure that any complications that the patient develops are looked at instantly. Management and Prevention Practices Despite being a costly disease to treat and manage, Stage 4 chronic kidney diseases can be highly preventable and treatable. Human economic burden that are posed by the disease can be reduced by ensuring that occurrence of the disease and its progression is prevented. If intervention measures are taken at one stage of the disease, its progression to the next stages can be delayed. Strategies should identify the three main levels of the prevention that include primary, secondary and tertiary level. Prevention measures aim to reduce exposing factor that lead to ill health (Newman 2009). The risk factors that may result from this condition, such as high blood pressure, should be prevented to avert the risk from spreading to many people. Measures of early detection and effective intervention with the aim of preventing the disease should be established. Tertiary prevention should focus at reducing the risk of progression of this disease to other levels as well as delaying complications that are long-term, impairments and any disability (Daugirdas 2011). Management and prevention can also be done by testing the GFR of individuals in the clinics in order determine the measures that should be taken (Kopple 2013). Other factors such as inter-current illness, underweight, obesity and dietary intakes should be considered. The measures of management and prevention of sickle cell disease should aim at ensuring patients have regular medical checkups to establish the severity of the disease (Wailoo 2006). Early identification measures of the disease should be put for the young people in order to counter the progression of this condition (Jones 2008). Hospitals and other health centers should launch medical checkups in the young children to ensure that they counter the disease as early as possible (Jamʼa 2002). Patients with the conditions should be advised on measures they can put into place to better their health conditions. Findings From the findings of clinical assessment, measures of prevention and management, it is noted that patients with sickle cell anemia have impaired red blood cells, which harbors the intake of Oxygen into the deeper tissues of the body as the cells cannot pass through the narrow vessels. The hemoglobin level in the cells is reduced to a lower level that cannot support uptake of required Oxygen into the body. These may at times result in Oxygen debt in the body of the patient. Patients with these conditions, therefore, develop some difficulties in metabolism. The patient is found to have paler red blood cells than normal, which indicates that her hemoglobin has reduced to levels below normal; five percent hypochromic cells in the patients blood evidences this condition. However, there are measures that can be used as tools to boost the health conditions of the patient. They include regular transfusion of blood to reduce the levels of hypochromic cells as well as giving the patient more blood cells that can assist in transport of Oxygen. The findings also indicate that patients can be educated on how to live in a society where parents should be educated on how care for their children. Early identification is apparently the best measure that can help prevent the condition. On the other hand, patients with Stage 4 chronic diseases have been found to have higher Ferritin in the blood than normal as their kidneys are unable to excrete them. In addition, it has been found that LSAT is below the normal percentage. However, there are measures that could help to improve the conditions of the patient in regard to this condition such as regular dialysis practice, which can help to clean up the toxins that accumulate in the blood. There are other dietary measures that the patient should consider in order to boost their conditions, including low intake of protein rich food and food that is rich in carbohydrates (DeMotte 2002). The finding from clinical assessment of the patient indicates that the condition has resulted in high blood pressure. However, this condition can be improved through kidney transplant on patients. Early identification this condition can help to prevent progression to the other levels. Patients with these conditions are encouraged to seek regular medical advice and checkups to prevent the occurrence of further complications (Brunk, 2011). Future recommendations Testing GFR in the clinics is preferred in order to establish the needs and conditions of the patient. This will help to prevent and manage the conditions in the future, hence reducing the risk factors those patients may come. Strategies should be made to identify the infection at early stage, to enable develop skills and measures that will help to curb the spread of the disease. Early analysis of the illness will help to come up with the relevant measures to the disease. People should be educated how avoid, prevent and create awareness on its impacts on human health. Institution of learning and schools should also assist in educating the public the impacts of the illness, in order to equip them with relevant measures to protect them from contracting the illness. Campaign with lobby groups also creates awareness to people by enlightening them with required information for the disease. The government should employ health specialist to help people with necessary medication and advice them on the importance of taking precaution; it should also provides funds to control the spread of the disease. Media and social media should be used to educate people with the relevant precaution by use of article, television, radio and newspapers. Health centers should come up with a program in the future, which will help to check up the patients for these conditions. The patients should be encouraged to have their children checked early and regularly to reduce the rate of occurrence of these conditions. It is also recommended that the public should be educated on the signs and symptoms associated with these conditions so they can seek medical attention immediately they come across them. Conclusion In conclusion, patients that experience the conditions of chronic kidney disease (CKD), and sickle cell disease (SCD) experience various complications within their bodies. These conditions can worsen if there are no interventions put in place. However, the conditions can be improved if measures are put on patients with these conditions. Dialysis, being one of the clinical measures that are used by the patients who have chronic kidney disease (CKD), helps boost the conditions of the patient. There are, however, other interventions that could be enhanced to prevent the condition. Dietary measure can also help the patient improve the condition and reduce future implications. Patients with sickle cell disease (SCD) have impaired red blood cells, thus, reducing the amount of hemoglobin in the blood tissue. Therefore, regular transfusion of blood on the patient can come in handy. Patients with these conditions need regular checkups in order for urgent measures to be taken in case of complications. These conditions can, however, be prevented if proper measures are put in health care. Early identification can help rectify them, thus preventing their progression to the other levels. Therefore, education of the public on the measures to put should be done to reduce the severity of these conditions. References Brunk, D., 2011, January 1. Many are unaware of their chronic kidney disease.(KIDNEY DISEASE)(Report). Family planning news. 4, 35. Chaudry, R. A., 2009. Cardiopulmonary function in children with sickle cell disease. London: University of London. Daugirdas, J. T., 2011. Handbook of chronic kidney disease management. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health. DeMotte, C. A., 2002. A Nutritional guide for persons with kidney disease. Santa Monica, CA?: California Dietetic Association, Los Angeles District. Flynn, J. T., 2013. Pediatric hypertension (3rd ed.). New York: Humana Press. Copy & Paste | Parenthetical Goldsmith, D., 2007. Kidney disease. Malden, Mass.: Blackwell Pub.. Greenberg, A., & Cheung, A. K., 2009. 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