CKD is a common severe illness in the United States and is associated with high morbidity and mortality rates. Patient with CKD presents with various symptoms, including peripheral edema, oliguria, fatigue, and weakness (Wang et al.,2021). Various nursing interventions need to be taken to care for such patients. Concept maps help to highlight the individualized plan of care. Therefore, a concept map was developed showing a care plan for D.K., a patient with CKD secondary to hypertension and diabetes.
Patient Needs Analysis
The most urgent nursing diagnosis for D.K. is impaired, ineffective renal tissue perfusion. The patient presents with some symptoms indicating that she may have impaired tissue perfusion, including oliguria, fatigue, and lower limb edema. The patient sometimes skips taking her medications and does not adhere to her dialysis sessions. She reports being tired of taking medications every day. The second most crucial nursing diagnosis for D.K. is impaired urinary elimination. The patient reports having decreased urine output and peripheral edema. The third important nursing diagnosis is decreased cardiac output. The patient had elevated blood pressure and tachycardia. Therefore, continuously monitoring the patient’s vitals is needed to ensure no further complications occur (Chen et al.,2019).
Patient and family education is essential to D.K. and her family. The patient needs to be taught the proper diet to eat, which includes meals with a reduced level of fats. Additionally, the patient needs to limit the amount of sodium/salt they take and the amount of proteins. The family taught how to care for the patient and the need to ensure the patient takes all the medications as indicated and can attend all dialysis sessions. Patient education also involved the need for the patient to stop smoking as it contributed to the poor prognosis of CKD. Both the patient and the family members were involved in the care the patient received. With Covid 19 pandemic, patients with CKD were significantly affected due to their compromised health status (Jdiaa et al.,2022). The patient’s social and economic status also contributes to poor outcomes.
Some cultures believe in herbal medications and use them to treat various diseases. D.K. reports having used herbal supplements to stay healthy. Therefore, the patient and the family need to be educated on herbal supplements not being safe for kidney disease as they further hurt the kidney and worsen it (Ladwig et al.,2019). The patient used to be a business lady but cannot work well with her current condition. The patient may find it hard to obtain the proposed CKD and diabetic meals. Therefore, the patient is linked to a care support group.
Ethnicity also plays a part in developing some health conditions, including diabetes. Africans are at risk of developing type 2 diabetes and hypertension and are at high risk of experiencing complications. This is because of their poor nutrition, as most of them cannot afford food to maintain good, well-balanced nutrition. Besides, they rarely carry out physical activities, a risk factor for developing several disorders. When it comes to healthcare, they face discrimination because of color, and thus their conditions progress to severe complications. In the care of D.K., the patient is treated and managed well, ensuring all her needs are met without discrimination. The patient is a Muslim, her religious culture was respected, and female providers attended to her (Swihart et al.,2021).
Communication Strategies
What the healthcare providers may want to share with the patients may not align with what the patients and their families want to hear. Healthcare providers must incorporate good communication to ensure they can agree with the patient and their families concerning the patient’s care. Patient-centered communication is critical as it significantly contributes to a better outcome for the patient. To effectively communicate the interventions to the patient and her family, there Is a need to incorporate active listening, where the patient’s beliefs and preferences are heard and considered.
Besides, the language used when communicating with the patient should also be considered. Plain language with no stigma was incorporated to ensure the patients and their families were able to understand the information delivered. The information was clear, nonjudgmental, respectful, based on facts, and neutral (Chichirez and Purcărea,., 2018). There is a need to establish rapport and ensure the patient trusts you to be free to give information concerning their health. Besides, healthcare providers should assure the patients of the privacy and confidentiality of their information. D.K. could not understand English well, and thus a translator was involved in facilitating communication. Effective communication significantly contributes to adherence to the treatment regimen and can promote understanding of the patient’s condition and how to take care of themselves. Furthermore, communication promotes satisfaction for healthcare providers, patients, and their families.
Value and Relevance of resources
The resources used in the concept map to give evidence on the care and management of D.K., a patient with CKD, are credible and contain reliable information concerning the disorder. The journal of healthcare engineering provides information concerning the nursing care of patients with CKD to prevent the progression of the disease to more severe complications, including ESKD (Wang et al.,2021). The resources used are peer-reviewed, thus ensuring a wide range of information concerning interventions for the care of CKD is available. Additionally, the book helps guide the relevant and priority nursing diagnosis for patients with CKD. Furthermore, the journal used all contain relevant and credible information on CKD.
Conclusion
CKD is a severe healthcare disorder that requires various interventions for a better outcome for the patient(Wang et al.,2021). When coming up with the interventions, the patient should be involved in the decision-making of their care. Evidence-based practices must be incorporated in coming up with interventions to ensure the most up-to-date and reliable sources to help provide appropriate care. Effective communication with respect to patients’ rights, cultures, and lifestyles should b put into practice to ensure better patient outcomes and promote patient satisfaction.
References
Chen, T. K., Knicely, D. H., & Grams, M. E. (2019). Chronic Kidney Disease Diagnosis and Management: A Review. JAMA, 322(13), 1294–1304. https://doi.org/10.1001/jama.2019.14745
Chichirez, C. M., & Purcărea, V. L. (2018). Interpersonal communication in healthcare. Journal of medicine and life, 11(2), 119–122. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101690/
Jan, S. S., Mansour, R., El Alayli, A., Gautam, A., Thomas, P., & Mustafa, R. A. (2022). COVID-19 and chronic kidney disease: an updated overview of reviews. Journal of nephrology, 35(1), 69–85. https://doi.org/10.1007/s40620-021-01206-8
Ladwig, G. B., Ackley, B. J., Flynn Magic, M.B., Martinez-Kratz, M., & Zanotti, M. (2019). Mosby’s guide to nursing diagnosis (Sixth ed.). Elsevier, Inc.
Swihart DL, Yarrarapu SNS, Martin RL. Cultural Religious Competence In Clinical Practice. [Updated 2021 Dec 2]. In: StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493216/
Wang, Y., Sun, Y., Lu, N., Feng, X., Gao, M., Zhang, L., Dou, Y., Meng, F., & Zhang, K. (2021). Diagnosis and Treatment Rules of Chronic Kidney Disease and Nursing Intervention Models of Related Mental Diseases Using Electronic Medical Records and Data Mining. Journal of healthcare engineering, 2021, 5187837. https://doi.org/10.1155/2021/5187837
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