Benchmark Paper

Risk factor

For my patients, being at the age of 70yrs and her belief on traditional herbal remedies, she will likely have to experience some risk factors which are, Diabetes, Obesity heart and blood vessel diseases. Among these risk factors, there are other factors which the patients can change herself and others she can not.  Most of these non-modifiable risk factors are heart disease and high blood pressure. Other risks like obesity and diabetes are modifiable when the patient follows a certain set of living instructions Cederholm &  Barazzoni, (2017).

Pathophysiology of illness

According to the test result and the coalition of the patients, she will likely have to experience the following signs and symptoms. Dark in urine, anaemia, hypertension, decreased urine outputs, decreased mental alertness, fatigue and edema, which results in swelling feets ankles and hands. The patient will suffer from anaemia, basically due to the partial loss of kidney functions. Note that kidney anemia is the loss of red blood cells in the body than normal. Due to her coalition, the red blood cells might fail to transport oxygen to the body tissues, thus resulting in the body tissues failing to use the energy from the food.

Anaemia result weakens red blood cells thus carrying less oxygen to body tissues, specifically the heart and the brain.  Due to the age of the patient, it directly reflects that anemia will be more common in her life. This is because it usually attacks older people above the age of 65 years old.  It is accompanied by a dizzying array of underlying health conditions in which the outcome can be anything from an emergency to a mild chronic issue which makes the local doctor care blink. This kind of system begins to develop in the early stages of CKD when someone has approximately 20 to 50 % of the normal kidney functions. On the other side, blood in urine is another severe symptom the patient will experience. This is a problem resulting from the urinary tract or the kidney. It is also known as hematuria. Hematuria is caused by a decrease in haemoglobin.

Surprisingly, the chronic renal disease mostly affects the lives of older individuals. To my patient, at the age of 65yers old, she is considered as an elder. To her life, the disease has judged her lifespan period and more so the health care cost. Her health quality will depreciate due to over three years for beneficiaries and with diabetes and stroke.

Diagnostic testing

The diagnostic testing to be carried for the patient mainly is the urine test. This will help in identifying the level of the protein albumin in her urine. In which a high level of albumin will detect the presence of kidney disease. Also, the patient may go through an imaging test like computer tomography scan, or ultrasound just to gauge the kidney structure and size looking for abnormality Miftahus Suroor & Yamaoka, (2016).

Lab values

When testing the patients suffering from chronic renal disease basically involves urine analysis, basic metabolic panel,  complete blood counts (CBC) and creatinine clearance. All this including the calculations of renal activities. The main reason for the urine test is to examine the serum albumin since the patient may be suffering from hypoalbuminemia, which is caused by lack of protein in the urine. The importance of this test is that they can help to identify the alarming signals of kidney disease like Glomerulonephritis, kidney stones and also urinary tract infections. Creatinine clearance is a test conducted to detect the degrees of creatinine from both a sample of urine and a sample of blood for every 24 hours. Note that when these patients result in a decrease in creatinine clearance, this will be an indication that the patient will likely have to experience a decrease in the kidney functions.

Medications

The following table shows the prescribed medicines for my patients with their generic names, brands, side effects and the nursing considerations.

 Abnormal Assessment Findings

When giving medicine and all the treatment required to this old woman, I will expect some abnormality with her, which is a result of medication. Among then are anxiety, delirium, suicide and depression. Therefore, it will take my consideration and attention to the patients to ensure that these abnormalities do not affect her life. In which, I will be required to deliver total communication and advice to the patient to show her she can still make it and fight the disease.

Analysis

When attending to the patient, I realized that she has three main problems in fighting her health. They include,

• Mental health
• Immunization
• Tobacco

Planning

With such information in mind about my patient, I have strategized several ways to deal with each of the issues.  On the side of mental health,  I realized that she is experiencing dementia as a result of responding to medicine, hearing problems and her vision.  This issue has resulted in depression, and I believe if I leave this untreated, it can result in suicide. Therefore, my effort lies in encouraging the patient to eat healthy, avoid too many alcoholic drinks, to exercise her mind and at least to ask her to be responsible  for her life. Immunization is another factor with my client. Note that pneumonia and influenza are the top causes of death among elderly people. Therefore I will put much emphasis on the influenza vaccinations and pneumonia although pneumonia has remained a  crucial infection mostly to women who are aged.

The next move will be based on the reduction of tobacco. In the United state of America, tobacco has remained the leading prevention of illness and the cause of premature deaths. Currently, if referred to as “Tobacco dependence disease.”  which stands for the centre of disease control and prevention, but with my effort and advice, I will ensure that the patients quit from tobacco slowly by slowly which I do believe she will overcome.

Interventions

The three goals aiming to my patients are,

• Management of her respiratory conditions
• Protection from other diseases
• Managing stress, depression and anxiety.

Evaluation

There are three ways of evaluation of whether the patients have attained the three goals. These ways includes

• Recognizing the normal thoracic and abdominal movements
• Conducting regular treatments programs with my patient for progress and signs.
• I Confirming if the patient is protecting her sleep and meditation as well as relaxing her muscles.

Clients Teaching

According to the progress of the patient, she is free to leave home from the health facilities through under supervision and advice. For the better of her health, I would encourage her to exercise regularly to relax her muscles and to feel free. Also, she should attend to various medical attendance and avoid alcoholic drinks as well as tobacco which may lead to prevention illness. The patient should have enough sleep and ensure she meditates now and then to avoid dementia which results in too much forgetting.

Besides, she should keep off from the things which remind her of her past painful moments resulting in stress and depression. The family should ensure that the patient does not suffer from loneliness. Also, they should ensure that the patient attends to medication as prescribed by the doctor. The family members should ensure that the patient is well consuming a balanced diet and has nothing to stress her. Due to her age, she needs their total attention and help from them to cope with this situation.

Culturally competent care

Based on culture trends, their influence is boundless. This is because it affects the perception of death, illness about the causes of the diseases, how the pain is being experienced and expressed, the types of treatments a patient would prefer and where to seek help. In my case, the patient trusts so much on the herbal medicine remedies, which she claims they could heal her situation. This is according to the belief of her culture, and since it is hard to stop her from her trust, I just have to add some advice on which herbal remedies she could use. Note that illness is all about what a patient beliefs in and according to psychology, anything that a patient considers to be medicine to her situation can heal the situation. Although intervention by a health expert will be required to guide the patient through.

Reference

Miftahus Suroor, M., & Yamaoka, Y. (2016). Diagnostic methods of Helicobacter pylori infection for epidemiological studies: the critical importance of indirect test validation. BioMed research international, 2016.

Cederholm, T., Barazzoni, R., Austin, P., Ballmer, P., Biolo, G., Bischoff, S. C., … & Jensen, G. L. (2017). ESPEN guidelines on definitions and terminology of clinical nutrition. Clinical nutrition, 36(1), 49-64.