55 P4

 

Instructions

Locating Resources

Locate a minimum of three community or national resources for your illness group chosen in Week 1, preferably in your community. Study these resources and write a report about them in a 4- to 5-page Microsoft Word document. Include in your response all the information the patient should know about them (the specific services they offer, fee schedules, if and when appropriate, criteria for eligibility, and any other important information). Discuss potential advantages and disadvantages for vulnerable populations in seeking these resources.

Support your responses with examples.

On a separate references page, cite all sources using APA format.

• Use this APA Citation Helper as a convenient reference for properly citing resources.
• This handout will provide you the details of formatting your essay using APA style.
• You may create your essay in this APA-formatted template.

Running head: MEDICAL CARE PLANNING FOR PATIENTS WITH CHRONIC KIDNEY DISEASE

Medical care planning for patients with Chronic Kidney Disease

Norys Gil

South University

Medical care planning for patients with Chronic Kidney Disease

Introduction

Chronic Kidney is a disorder that disturbs the correct working of the kidney, which is increasingly becoming a challenge to the health care sector. Just like any other chronic disease, CKD comes with the responsibility of ensuring that a patient gets maximum medical treatment facilities and attention as much as possible. “The definition and classification of  chronic kidney disease (CKD) have evolved, but current international guidelines define this condition as decreased kidney function as shown by  glomerular filtration rate (GFR) of less than 60 mL/min per 1·73 m2 or markers of kidney damage, or both, of at least three months duration, regardless of the underlying cause”, Morton & Masson, 2017.

Morbidity and comorbidity of chronic Kidney disease

Weak/low results are closely associated with CKD; this is because of the burdens that are so high when it comes to comorbidity. Many pieces of research have indicated that CKD relates to diabetes and hypertension conditions. Intense conditions of chronic kidney disease also lead to heart complications. There is little information on the mental difficulties that come with CKD.

“Chronic kidney disease (CKD) can be associated with adverse clinical outcomes, poor quality of life, and high health-care costs; clinicians need to understand that these observations result from a high burden of comorbidity among CKD patients”, (Manns &Hemmelgarn 2010). Key morbidities of CKD, therefore, include pulmonary complications, diabetes, hypertension, and atrial fibrillation. CKD, to a very high degree, leads to characteristics such as myocardial infarction, dementia, hypothyroidism, depression, and stroke. All comorbidities remain classified as concordant others that closely relate with CKD but ranked as discordant include; asthma, constipation, lymphoma dementia, etc.

Impacts of chronic kidney disease

Various medical reports by the health care agencies and organizations, including the World Health Organization show that CKD is a growing complication that has become a big concern of the public health care sector not just in the United States but around the globe. An estimation of over 26 million people is affected by CKD in the country. Annual reports have shown that this number is likely to increase if serious investments are in the health care sector. Hypertension and diabetes are proven, leading causes of kidney complications. To an individual, CKD can lead to other primary complications such as nephropathy, lupus, and continuity of kidney failure. The country invests billions of money annually, something that is becoming hard to sustain because of the annual increase in population and the number of those affected by CKD.

As of 2006, over $23 billion was spent on CKD and other related chronic complications, and this is a clear indication that with CKD comes a substantial financial burden not only to the affected person and his/her but the society at large. Although CKD complications cannot be changed, its progression rate may be measured. For this rate to be measured successfully, a lot of emphases must be put on developing outstanding strategies that will make it easy when it comes to the identification of people who have high chances of being affected by CKD for early screening to be done.

Key goals and objectives for chronic kidney diseases

According to Healthy People 2020, CKD, together with ESRD (End-Stage Renal Disease are among the most critical challenges facing the public health care sector. It is also a vital source of the low quality of life and suffering to the affected people, the family, and society in general. A lot of premature death cases are rising from CKD and high prices within the economy both within the public and the private sector. The most crucial aim that Healthy people seeks to achieve is reducing the rise of recent cases as far as CKD is concerned, and this is the inclusion of all the other difficulties that come hand in hand with CKD, lowering death rates, disability cases related to CKD, and the enormous economic expanses.

The objectives include, “reducing the proportion of the U.S population with CKD, increasing the percentage of people with CKD that know they have impaired renal function, increasing the actual percentage of hospital patients that have incurred kidney injuries that have a follow-up evaluation of renal in within six months of post-discharge, Increase the proportion of persons with diabetes and chronic kidney disease who receive recommended medical evaluation, Increase the proportion of persons with chronic kidney disease who receive medical evaluation with serum creatinine, lipids, and micro albuminuria, Increase the proportion of persons with type 1 or type 2 diabetes and chronic kidney disease who receive medical evaluation with serum creatinine, micro albuminuria, A1c, lipids, and eye examinations, Increase the proportion of persons with diabetes and chronic kidney disease who receive recommended medical treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBS) and Improve cardiovascular care in persons with chronic kidney disease”, (Healthy People 2020).

Care plan for C.K.D patients

1. Monitoring the most important factors which are essential in maintaining consistent blood pressure. This monitoring is an excellent way through which the kidneys get protected from more damages.

2. Monitoring and managing the blood sugar level is vital in reducing the stress that the kidneys may face

3. Assessing the cardio-pulmonary systems, “Fluid retention from improper glomerular filtration may collect in the myocardium resulting in pressure on the heart and the lungs. Listen for friction rub and pulmonary crackles or congestion”, NSRNG 2019.

4. Monitoring laboratory and diagnostic evaluations. “Purification Degree (GFR) <60 indicates kidney disease, <15 indicates kidney failure, CT / Ultrasound Kidney biopsy (if necessary), Chest x-ray - if indicated GFR- is a blood test that can show the degree of kidney function available. It is a calculation of creatinine levels, race, age, and gender. CT / Ultrasound- this imaging may be helpful to view the kidneys to determine if there are tumours or other unusual characteristics of the organs”. Hill, N. R., Fatoba, S. T., Oke, J. L., Hirst, J. A., O’Callaghan, C. A., Lasserson, D. S., & Hobbs, F. R. 2016

5. Evaluating the mental state of the patients.

6. Monitoring I & O is carried out by monitoring the functioning of the kidney, calculating the level of fluid retention, the patient’s weight daily at the proper planned time.

7. Inserting an indwelling catheter appropriately, this is a better way of monitoring the fluids balance plus urine features.

8. Palpating the patient’s abdomen, this is a better way of assessing the level of fluid retention.

9. Another meaningful way is Focusing on nutrition guidelines. “The kidneys are compromised and unable to remove the waste produced by processing proteins (BUN). Choose foods low in saturated and Tran’s fat to prevent and lower fat deposits in the blood vessels. Choose lower potassium foods to avoid hyperkalemia caused by excess potassium retention”. Hall, M. E., do Carmo, J. M., da Silva, A. A., Juncos, L. A., Wang, Z., & Hall, J. E. 2014.

References

Webster, A. C., Nagler, E. V., Morton, R. L., & Masson, P. (2017). Chronic kidney disease. The Lancet, 389(10075), 1238-1252.

Chawla, L. S., Eggers, P. W., Star, R. A., & Kimmel, P. L. (2014). Acute kidney injury and chronic kidney disease as interconnected syndromes. New England Journal of Medicine, 371(1), 58-66.

Collins, A. J., Foley, R. N., Gilbertson, D. T., & Chen, S. C. (2015). The United States Renal Data System public health surveillance of chronic kidney disease and end-stage renal disease. Kidney international supplements, 5(1), 2-7.

Hall, M. E., do Carmo, J. M., da Silva, A. A., Juncos, L. A., Wang, Z., & Hall, J. E. (2014). Obesity, hypertension, and chronic kidney disease. International journal of nephrology and renovascular disease, 7, 75.

Hill, N. R., Fatoba, S. T., Oke, J. L., Hirst, J. A., O’Callaghan, C. A., Lasserson, D. S., & Hobbs, F. R. (2016). The global prevalence of chronic kidney disease–a systematic review and meta-analysis. PloS one, 11(7), e0158765.

Appendix

Questionnaire

NAME: …………………………………………… RESIDENCE: ……………………………

GENDER: …………. OCCUPATION: ………………………. QUALIFICATION: ………

SPECIALTY: ……………………. DESCRIPTION: …………………………………………

ORGANIZATION: ……………………………………………………………………………….

EMPLOYEMENT CONTACT: …………………………………………………………………

TELEPHONE NUMBER: ………………………………

SERIAL NUMBER

QUERY

AGREE

DISAGREE

CANT TELL

Antibiotic prescribing

Almost each antibiotic chronic kidney disease is not safe

Reports on human cultural concern should be agreed upon before recommending the use of the.

According to your view, in chronic kidney disease health sector needs to focus on using the index from therapies.

The amount of medical dosage should be low for patients with CKD.

The use of antibiotics on patients with CKD should be patterned.

Anuria essential consideration while prescribing antibiotics in CKD.

Antibiotic prescribing

When dealing with CKD, sulfonamides are important for UTI

Aminoglycoside is the best drug that can be cast-off for patients with CKD.

Running head: IMPACTS OF RENAL DISEASES

Impacts of Renal Diseases

Norys Gil

South University

Impacts of Renal diseases

Case study

This research collected information from my neighbor, a 44-year-old woman. The patient has been complaining about the worsen kidney complication. Her complications developed five years ago. The patient would frequently complain about high blood pressure, nausea, foamy and dark colored urine, loss of appetite, general body weakness and loin pain. It was important therefore to check if the patient understood her condition in terms of associated health risks, care and medication schemes, and her perception towards the complication (Franczy, et al., 2016, p. 260).

The patient confirmed that she is overwhelmed by the medical complications and she would like to understand a proper course of action to follow in managing the disease. The patient explains that her condition started when she first experienced knee pain. Since she was an active smoker and obese, she was advised to quit the menace and reduce body weight by her family doctor. In the initial stages of complications, the mediations such as ibuprofen, that were prescribed by the physician seemed helpful. However, after one year, she developed further complications which led her to visit other doctors. One of the doctors determined that she had a stage 3 chronic kidney three after conducting blood tests. The doctor did not prescribe medication or any programs for managing the condition. The following involves the responses from the patient in a questionnaire.

The questionnaire and responses

Initials Mrs. First Name: …………………… Last Name: ………………………….

Telephone:…… ………………. Email address: ………………………………………..

Thank you for participating in this study. Filling in this questionnaire will enable you to have insightful ideas as well as enabling the researcher to understand the community’s perception and knowledge regarding kidney complications.

1) Are you aware of treatment plans for your health conditions?

The physician prescribed a medication scheme consisting of diuretic, calcium reduction, stimulation of bone marrow, and some diet supplements. I was advised to quit smoking and consume low proteins.

2) Do you experience challenges in managing chronic kidney disease?

Quitting smoking is challenging as well as keeping a healthy diet.

3) Do you have any health primary concerns? What are they?

My only health concern is wondering whether or not I will long enough to see my grandchildren.

4) Are there any measures you can do to improve your current health status?

I would like to follow all medical plans prescribed by the doctor such as to quit smoking, reducing body weight and having a healthy diet.

5) Do you experience financial challenges in meeting your medical requirements?

I have not experienced any financial challenges in meeting my medical bills.

6) What do you understand with regards to obesity, smoking, and a healthy lifestyle?

I have learned from the physician that smoking, obesity and lack of enough physical activities or exercises are predisposing to chronic kidney complications.

7) Do you understand the complications and risks associated with chronic kidney diseases?

Initially, I thought that my deteriorating health status will cause my death soon enough. Recently, after learning from my physician, I understand that when toxins accumulate in the body due to failed kidneys, I could develop, more complications and diseases such as heart diseases, anemia, bone complications, and buildup of fluids in the body.

8) Are there signs of hyperglycemia that you are aware of?

Yes, conditions such as blurred vision, frequent urination, and feet numbness can be an indication of hyperglycemia.

9) Do you know the causes of hyperglycemia?

Low levels of insulin and insulin resistance are the likely causes of hyperglycemia especially in patients suffering from diabetes according to my physician.

10) Do you experience challenges when performing tests such as blood sugar and urine test?

I do not; I am ready to take any necessary tests to receive an accurate diagnosis for reliable medical plans.

11) Do you understand various prescribed medications?

Can you administer insulin correctly when it is prescribed?

I do not understand various prescribed medications. Equally, I am unable to draw up and administer insulin when it is prescribed because I failed to meet any physician when I went for further tests in the health center for initiating the care plan.

12) Are there helpful and unhelpful medication prescription?

Ibuprofen is essential in managing body pain. The last doctor I visited explained that there are various treatment schemes for the disease, however, he failed to prescribe any medications because he wanted to perform more tests to determine a proper medical plan.

13) Is there any complication due to the side effects of certain medications that you recurrently experience?

I am yet to undergo care plans and thus I have not experienced any difficulties and side effects from medication.

14) Is there an additional medication that you are currently taking and have not been mentioned?

I have been taking propranolol and diazepam for managing stress levels and antihistamines for itches.

15) What is your general feeling about chronic kidney diseases? Has the complication changed your lifestyle?

Managing the disease is my primary concern because I feel it can claim my life if it is not adequately managed. Changing eating habits, quitting smoking and starting physical exercise have significantly changed my lifestyle.

Discussion and Analysis

The responses collected by the questionnaire from the patient indicate that she is having challenges to cope up with her health condition. Her condition I likely to deteriorate despite that she has undertaken several tests. This is due to various reasons such as lack of reliable and effective care plans, failing to quit smoking and consumption of food rich in fats. The care plans should, therefore, constitute isotonic fluids for controlling body fluid levels, controlling of hyperkalemia by the use of insulin, and salbutamol (Gluba-Brzozka, Franczyk, & Rysz, 2019).

Healthy diets and healthy lifestyle practices, for example, quitting smoking and having at least one-hour sessions of exercise per day in three days of the week can increase the chances of survival and lifespan of patients who are already experiencing kidney complications and renal diseases. The patient under study has also indicated that she has not received proper medication or care plans to manage her condition (Rysz, et al., 2017).

Management of renal diseases and associated complications

The patient under study could suffer from both hypertension and diabetes. These two conditions are risk factors for renal diseases. Therefore, care programs should consider other measures such as reduction of body weight and controlling of blood sugar levels. It is therefore important to roll out changes immediately to prevent the condition from progressing to complex stages such as kidney failure. Frequent dialysis and kidney transplant are also potential remedies for renal diseases. Change of lifestyle in terms of healthy eating habits, regular exercise and avoiding smoking are essential schemes for managing the condition at its early stages. Proper medications prescribed by a physician are essential for managing conditions such as stress and blood sugar levels (Gluba-Brzózka, et al., 2018).

References

Franczyk, B., Gluba-Brzózka, A., Cia|kowska-Rysz, A., Banach, M., & Rysz, J. (2016). The Problem of Atrial Fibrillation in Patients with Chronic Kidney Disease. Current Vascular Pharmacology, 14(3), 260-265. doi:10.2174/1570161114666160115130836

Gluba-Brzozka, A., Franczyk, B., & Rysz, J. (2019). Cholesterol Disturbances and the Role of Proper Nutrition in CKD Patients. Nutrients, 11(11), 2820. doi:10.3390/nu11112820

Gluba-Brzózka, A., Franczyk, B., Ciałkowska-Rysz, A., Olszewski, R., & Rysz, J. (2018). Impact of Vitamin D on the Cardiovascular System in Advanced Chronic Kidney Disease (CKD) and Dialysis Patients. Nutrients, 10(6), 709. doi:10.3390/nu10060709

Rysz, J., Franczyk, B., Ciałkowska-Rysz, A., & Gluba-Brzózka, A. (2017). The Effect of Diet on the Survival of Patients with Chronic Kidney Disease. Nutrients, 9(5), 495. doi:10.3390/nu9050495

Running Head: APPROPRIATE INTERVENTIONS FOR HEALTHY PEOPLE

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APPROPRIATE INTERVENTIONS FOR HEALTHY PEOPLE 2020

Appropriate Interventions for Healthy People 2020

Norys Gil

South University

List of Support Needs for the Participant

1. Assisting the patients to change the lifestyle is one of the primary support needs. According to the participant response, quitting smoking and maintaining a healthy weight are some of the significant challenges. Educating the patient about healthy dietary and the need for vigorous physical exercise will help the patient in maintaining the right body weight. Smoking habits are highly addictive, and quitting becomes challenging and requires significant effort from both the patient and the caregiver.

2. Psychological counseling. The patient has a great concern of wondering if she would leave long to see grandchildren. She also takes medication such as propranolol and diazepam for managing the stress. Counseling will help the patient mitigate the effects of anxiety and possible depression. It will also change the mindset of imminent death as a result of chronic kidney complications. Physical exercise is essential for mental health and manages stress levels.

3. Accurate tests and prescriptions of the medical plan to the patient are essential in chronic disease management. According to the participant, she would like to follow the prescribed medical plan to manage this complication.

4. They are assisting the patient in understanding the various prescribed medical plan. There is a need to educate the patient about how to administer medicines such as insulin.

Objectives Implementation of Healthy People 2020

Healthy people in 2020 policies and laws examined the various opportunities and approaches to achieve their primary goals. Different governments are using different strategies to promote the health wellness of society and public health. These initiatives serve as roadmaps for different countries and their objectives to health promotion (Pykett, 2019). They provide a way for the government and the community in general to understand the current and future health situation for effective planning and policymaking. For effective interventions for healthy nations, the government needs to engage public health stakeholders such as the healthcare providers, practitioners, and the community. This will helps in the identification of effective strategies for interventions and making healthy people 2020 ideas actionable.

Good health begins in our homes, workplaces, schools, and community in general. Social determinants of health directly impact all individuals. The healthy people 2020 determinants are divided into various categories, namely economic stability, education, healthcare, and the neighborhood, built environments as well as the community context (Pykett, 2019). The first step of implementing objectives of Health People 2020 is the identification of the national-wide health improvement priorities. For an effective healthy people program, different sectors need to collaborate to identify the unique needs of the community. One of the significant areas for healthy people 2020 is access to food and healthy eating patterns. To implement this objective, we must find out how access to food and healthy eating impacts the general public health.

Healthy eating habits like eating a balanced diet, controlling calories, limiting the intake of saturated and added sugar can significantly help in lowering the chances of getting chronic diseases. Creating awareness through the help of healthcare professionals such as nurses, physicians, and the media will have significant positive impacts on the general public health. Access to healthy food has a direct contribution to the health wellness of an individual throughout their lifetime. However, there some challenges to healthy food access in our community. The average distance from home to the nearest food store or a supermarket is one of the primary challenges in ensuring access to healthy foods in our society. Individuals without proper means of transport will, therefore, face a significant problem in accessing healthy foods (Wheeler, 2018). Since the affordability of healthy eating is also another significant challenge, the government needs to create favorable policies that ensure the low prices of healthy food for a healthier nation in 2020 and subsequent years.

The other objective of Healthy People 2020 is proper access to healthcare services. Access to timely healthcare is one of the essential elements of a healthy nation and helps individuals to achieve the best possible healthcare outcome. The majority of individuals in our society face various barriers to timely access to healthcare services. This results in excellent healthcare disparity as well as reduced healthcare outcomes. Some of these barriers include inadequate health insurance coverage, limited care resources, and poor transportation, among others (Pykett, 2019). To increase health wellness in 2020 and beyond, the government, through the health and treasury departments, will have to ensure equal distribution of resources and insurance coverage for the citizens. This will reduce the out of pocket healthcare expenses that make individuals delay or forego visiting doctors, dentists, and access to other essential medical plans hence negatively affecting public health. Ensuring adequate access to primary care will have a positive impact on public health and increased wellness. Professional caregivers such as nurses and other medical officers also have a crucial responsibility of ensuring they provide the patient with accurate diagnosis and best care to the patients.

Health literacy is a crucial issue in the healthcare department. For a healthier nation, a collaboration between the government and healthcare providers will increase the degree of the individual capacity to obtain and understand necessary health information that is crucial in deciding personal health and healthcare (Wagner & Howe, 2019). Literacy will increase the individual’s capacity to take charge of their healthcare matters and that of their families. The individual with low health literacy will most of the time, not be able to understand simple drug prescriptions and other medical instruction form nurses and doctors. A collaboration of the healthcare providers and the government will ensure health literacy is made a priority to increase wellness and provide good public health in society.

Environmental conditions are another significant element that affects public health and wellness. Water contamination and extreme heats are some of the typical examples of how the environment may affect public health. According to the GHO, more than eleven percent of molarity cases in 2012 were associated with environmental causes (“GHO | By category | Deaths attributable to the environment – Data by country,” 2020). We need to identify environmental exposures and how they impact people in different geographical locations. Poor quality of the water increases the risk of public health. A good example is groundwater, which is used for growing crops and becomes contaminated for human consumption and may spread waterborne diseases. On the other hand, older adults and children are more exposed to hot air temperatures and risks getting heat-related illnesses. There is a need for effective policies and measures for protecting the public from drinking contaminated water and being exposed to high air temperatures for a healthy nation in 2020 and the coming years.

Professional caregivers are one of the most crucial stakeholders in healthcare interventions. Home nurses provide both psychological and multidimensional interventions in the health sector. They develop the best plans for specific situations and the need of the patients for adequate care. One of the benefits is flexible intervention according to the needs of different patients. The other appropriate response of a caregiver is the provision of emotional support to the patient. They can also intervene in providing legal and financial support for the patients who may no longer be able to care for them. The professional caregiver can also manage the medical care plan, which may include keeping medical records and administering medications according to the prescriptions. All these interventions have a primary goal of ensuring the patient receives the best healthcare and love from the family and society.

References

GHO | By category | Deaths attributable to the environment – Data by country. (2020), from

http://apps.who.int/gho/data/node.main.162

Pykett, J. (2019). Healthy Nations: Behavioural Approaches in Public Health Policy. In Behavioural Policies for Health Promotion and Disease Prevention (pp. 53-72). Palgrave Pivot, Cham.

Wagner, T., & Howe, C. (2019). Addressing Systemic Health Literacy Issues and Patient Safety through a Grassroots Collaborative. Journal of Consumer Health on the Internet, 23(1), 62-69.

Wheeler, A. (2018). The Financial Impact of a Healthy Eating Intervention in a Government Worksite Cafeteria.