ACTIVITY 1 Presentation about Glenda case

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1. Case study of glenda kerinaiu ACTIVITY 1 By: 220257534 carias , tiffany

2. Who is glenda ? Transferring care - retrieval Glenda is moved from the clinic to Royal Darwin hospital as part of this current hospitalization for additional research. Glenda is a seriously ill patient who needs immediate air transfer, which is an essential component of regionalized healthcare systems in isolated areas of Australia. These trauma systems, which rely on skilled teams with Royal Flying Doctors (RFDs), improve patient outcomes. They quickly handle and transport extremely ill patients, like Glenda, from remote regions to the closest suitable institution, in this case Royal Darwin Hospital, using a fixed-wing aircraft.

3. Who is glenda ? Emergency Department She is admitted to the renal ward under the supervision of Dr. Pell, a nephrologist. After inserting a vascath (CVC) and ordering a portable x-ray, ECG, and EUC, the Darwin emergency department is ready for Glenda when she arrives. Glenda is then taken promptly to the haemodialysis unit and started on haemodialysis that evening. In a week, she will undergo surgery to treat a fistula that has developed in her left arm.

4. Who is glenda ? Haemodialysis unit Glenda needed to begin hemodialysis (HD) immediately. This is not optimal, even having end-stage renal disease (ESRD). Short-term problems from dialysis are independent risk factors for urgent-start HD. Glenda was observed by a nephrologist at the outpatient clinic on the Tiwi Island for three months despite having a known prior history of chronic kidney disease (CKD). Despite this, Glenda developed an unanticipated acute renal function decline that necessitated immediate dialysis.

5. Why do some patients need emergency dialysis? Emergency dialysis may be necessary for patients who have acute kidney injury (AKI) or end-stage renal disease (ESRD) and experience sudden and severe symptoms that require immediate intervention. Here are some of the reasons why a patient may need emergency dialysis: High levels of potassium in the blood (hyperkalaemia): This condition can lead to heart rhythm disturbances and is a medical emergency that requires prompt treatment with dialysis. Fluid overload: Patients who have ESRD or AKI may experience fluid overload due to a buildup of excess fluids in the body. This can lead to heart failure and other serious complications that require emergency dialysis to remove the excess fluid.

6. Why do some patients need emergency dialysis? Uraemia: This occurs when waste products build up in the body due to kidney failure. Symptoms of uraemia can include confusion, seizures, and coma, and require immediate treatment with dialysis. Severe acidosis: This occurs when there is an excess of acid in the blood, which can lead to organ failure and other serious complications. Emergency dialysis can help to remove the excess acid and stabilize the patient. Drug overdose or poisoning: Certain drugs or toxins can cause kidney damage and require emergency dialysis to remove them from the body.

7. What is the difference between acute kidney injury( aki ) and chronic kidney disease ( ckd ) Acute Kidney Injury (AKI): AKI is a sudden and usually reversible loss of kidney function, which occurs over hours or days. It is usually caused by a sudden decrease in blood flow to the kidneys, damage to the kidneys themselves, or obstruction of the urinary tract. AKI can be a serious and potentially life-threatening condition, and it requires prompt medical attention. Symptoms of AKI may include decreased urine output, fluid retention, nausea, vomiting, and confusion.

8. What is the difference between acute kidney injury( aki ) and chronic kidney disease ( ckd ) Chronic Kidney Disease (CKD): CKD, on the other hand, is a long-term and progressive condition in which the kidneys gradually lose their ability to function properly. It may take years for the symptoms of CKD to become apparent, and the condition is often diagnosed through routine blood and urine tests. The most common causes of CKD are diabetes and high blood pressure, but other conditions, such as polycystic kidney disease or glomerulonephritis, can also cause CKD. Symptoms of CKD may include fatigue, swelling of the hands and feet, increased urination, and decreased appetite.

9. What is vascath cvc ? A Vascath CVC (Central Venous Catheter) is a type of catheter that is placed into a large vein in the body, usually in the neck or groin area, to allow for the delivery of medications, fluids, or blood products, and the collection of blood samples. The Vascath CVC is a type of tunneled catheter that consists of two separate lumens or channels: one for the infusion of fluids and medications, and another for the withdrawal of blood samples. The Vascath CVC is commonly used in patients who require frequent or prolonged access to their bloodstream, such as those receiving haemodialysis or chemotherapy. It can also be used in emergency situations when quick access to the bloodstream is needed. The Vascath CVC is inserted under sterile conditions by a trained healthcare provider and requires regular monitoring and maintenance to prevent infection and other complications. T he Vascath CVC is a valuable tool in modern medicine that allows for safe and efficient access to the bloodstream for a variety of medical treatments and interventions.

10. Pathophysiology of acute kidney injury. Imagine that the kidneys are like a water filtration system in your house. Just like how the water filtration system removes impurities from the water, the kidneys remove waste products and excess fluid from your blood. Now, let's say that there is a problem with the filtration system. This can happen in a few different ways: Prerenal AKI: This is like a problem with the water supply to the filtration system. If there isn't enough water coming in, the filtration system can't do its job properly. Similarly, if there isn't enough blood flow to the kidneys, they can't filter the blood effectively.

11. Cont. Intrinsic renal AKI: This is like a problem with the filtration system itself. If there is damage to the filtration system, such as from a clogged filter or a broken pump, the water won't be filtered properly. Similarly, if there is damage to the renal parenchyma, such as from toxins or ischemia, the kidneys won't be able to filter the blood properly. Postrenal AKI: This is like a problem with the drainage system after the water has been filtered. If there is a blockage in the drainage system, such as from a clogged pipe or a malfunctioning valve, the filtered water won't be able to leave the system. Similarly, if there is an obstruction in the urinary tract, such as from a kidney stone or tumour, the urine won't be able to leave the kidneys.

12. Cont. When the filtration system isn't working properly, waste products and excess fluid can build up in the body. This can lead to symptoms such as swelling, nausea, and fatigue. If left untreated, AKI can lead to complications such as electrolyte imbalances, acidosis, and even organ failure.

13. Pathophysiology of chronic kidney disease. Imagine that the kidneys are like a drain in your home. Just like how a drain removes waste and excess water from your sink, the kidneys remove waste products and excess fluids from your blood. However, if the drain becomes clogged, water can't flow properly, and the sink can become backed up with dirty water. Similarly, if there is damage to the kidneys, waste products and excess fluids can build up in the body. There are several stages of CKD, each with its own characteristics:

14. Cont. Stage 1: This is like a partially clogged drain. The kidneys are still functioning, but there may be signs of damage or reduced function, such as an increase in albumin levels in the urine. Stage 2: This is like a drain that is starting to become more clogged. There may be slight symptoms such as fatigue, but the kidneys are still functioning at a relatively normal level. Stage 3: This is like a drain that is becoming increasingly clogged. Symptoms such as high blood pressure and anaemia may develop, and the kidneys may not be able to filter waste products and excess fluids as effectively.

15. Cont. Stage 4: This is like a drain that is almost completely clogged. The kidneys are significantly damaged, and symptoms such as nausea, vomiting, and itching may develop. Stage 5: This is like a completely clogged drain. The kidneys have failed, and waste products and excess fluids are no longer being removed from the body. This stage of CKD requires dialysis or a kidney transplant to replace the function of the damaged kidneys.

16. Pathophysiology of stage four renal failure. T he kidneys are like a busy highway, and the blood flowing through them is like traffic. Normally, the kidneys can filter out waste and excess fluids from the blood, just as traffic can flow smoothly on a clear highway. However, in stage four renal failure, the kidneys are damaged and can't filter blood effectively. This is like a traffic jam on the highway, where the flow of traffic is slowed or stopped due to an accident or construction. Waste products and excess fluids start to accumulate in the blood, just as cars start to pile up on the highway.

17. Cont. As the traffic jam persists, more and more cars join the queue, just as more waste products and excess fluids build up in the blood. This can lead to symptoms such as fatigue, nausea, and swelling, just as drivers stuck in a traffic jam may feel frustrated, tired, and uncomfortable. If the traffic jam is not cleared, it can cause even more problems, such as accidents or damage to vehicles. Similarly, if stage four renal failure is not treated, it can lead to complications such as anaemia, bone disease, and heart disease.

18. Treatment regimen for patient with stage four renal failure. The treatment for a patient with stage four renal failure depends on the underlying cause of their kidney disease and the severity of their symptoms. However, some common treatments for stage four renal failure include: Medications: Medications may be prescribed to control blood pressure, lower cholesterol levels, and manage complications such as anaemia and bone disease. Your healthcare provider may also recommend medications to manage the underlying cause of your kidney disease, such as diabetes or high blood pressure.

19. Treatment regimen for patient with stage four renal failure. Dietary changes: A diet that is low in salt, phosphorus, and potassium may be recommended to help manage symptoms and slow the progression of kidney disease. Your healthcare provider may also recommend limiting protein intake to reduce the workload on the kidneys. Dialysis: In stage four renal failure, the kidneys are significantly damaged and may not be able to filter waste products and excess fluids from the blood effectively. Dialysis is a treatment that uses a machine to filter the blood when the kidneys are not functioning properly. There are two types of dialysis: haemodialysis, which uses a machine to filter the blood outside of the body, and peritoneal dialysis, which uses the lining of the abdomen to filter the blood.

20. Treatment regimen for patient with stage four renal failure. Kidney transplant: A kidney transplant may be recommended for patients with stage four renal failure who are otherwise healthy enough to undergo surgery. A kidney transplant involves replacing the damaged kidneys with a healthy kidney from a donor. Supportive care: Patients with stage four renal failure may experience a range of symptoms such as fatigue, nausea, and difficulty sleeping. Supportive care measures such as pain management, nutritional support, and emotional support may be recommended to help manage these symptoms and improve quality of life.

21. Nursing education Understanding the causes and risk factors for stage four renal failure, including the importance of managing diabetes, high blood pressure, and other chronic conditions. Understanding the symptoms of stage four renal failure, such as fatigue, nausea, and changes in urine output, and the importance of seeking medical attention if these symptoms occur. Understanding the importance of regular medical check-ups, blood tests, and other diagnostic procedures to monitor kidney function and detect any complications early. Understanding the role of dialysis and kidney transplantation in managing stage four renal failure, including the potential risks and benefits of these treatments.

22. Nursing education Understanding the importance of adhering to medication regimens, including any prescribed treatments for underlying chronic conditions, such as diabetes and high blood pressure. Understanding the importance of a healthy diet and lifestyle, including the importance of regular exercise, maintaining a healthy weight, and avoiding tobacco and excessive alcohol consumption. Understanding the importance of social support and community resources, including access to transportation, financial assistance, and culturally appropriate healthcare services.

23. Education for glenda and family RECOGNISE SYMPTOMS OF RENAL FAILURE Fatigue Nausea Changes in urine output (Wee)

24. Education for glenda and family Avoid smoking. Decrease Alcohol consumption.

25. Education for glenda and family Managing High Blood pressure. Monitoring Blood Sugar level,

26. Education for glenda and family I mportance of a healthy diet and lifestyle, including the importance of regular exercise.

27. Education for glenda and family Drink your water.

28. Education for glenda and family Visit your Doctor regularly. Importance of regular blood test and diagnostic procedures.

29. References: Finkel, K. W., Perazella , M. A., & Cohen, E. P. (2020). Onco-nephrology . Elsevier. Kellum, J. A., R Bellomo , & C Ronco . (2016). Continuous renal replacement therapy . Oxford University Press. National Kidney Foundation. (2017). Acute Kidney Injury (AKI) . National Kidney Foundation. https:// www.kidney.org / atoz /content/ AcuteKidneyInjury Sics Editore . (2014). Acute kidney injury . SICS Editore . Wisit Cheungpasitporn , Charat Thongprayoon , & Wisit Kaewput . (2020). Diagnostics, Risk Factors, Treatment and Outcomes of Acute Kidney Injury in a New Paradigm . MDPI.

30. Thank you! End.