Indications for Dialysis
Seeing that dialysis allows saving lives and is used in dire renal-related situations, the instance of a sudden illness or an acute manifestation of the related symptom can be considered the primary indications for the application of the identified strategy. For example, the instance of electrolyte imbalance, e.g., hyperglycemia, will warrant dialysis. Furthermore, when diuretics fail to help reduce the amount of fluid in the body the use of dialysis should be considered.
Another scenario in which dialysis will be considered a requirement is the presence of harmful substances in the patient’s body. For example, the patient may suffer from poisoning, which requires immediate dialysis. The identified situation typically includes chemical poisoning, i.e., abuse of medication, the presence of chemicals or their compounds in the patient’s organism, etc. The use of dialysis allows for complete clearance of the body from the substance that harms it.
Uremia and similar diseases may also become the reason for using dialysis as the means of addressing the patient’s needs. As urea and the related waste is accumulated in the patient’ body, the threat of poisoning becomes increasingly high. Therefore, dialysis must be used as the means of removing the waste material from the patient’s blood.
Finally, chronic diseases such as renal are typically viewed as the reason for dialysis. A drop in the glomerular filtration rate (GFR) is typically interpreted as the indication for the necessity to start the procedure. Unless other drugs may resolve the issue, dialysis is used (Nesrallah et al., 2014).
Need for Peritoneal Versus Hemodialysis
Although both hemodialysis and peritoneal are used to treat kidney disease and remove accumulated fluid from the body, these approaches are slightly different. Hemodialysis suggests that a device that consists of a membrane should be used to filter the elements that are toxic to the human body and remove them successfully.
Peritoneal dialysis, in its turn, uses a slightly different approach to filtering the patient’s blood. Particularly, instead of using an artificial membrane to carry out the process, the identified approach involves using the peritoneal membrane, which is located in the patient’s abdomen, and a solution known as dialysate to remove the toxic products from the patient’ organism (National Institute of Diabetes and Digestive and Kidney Diseases, 2016).
Therefore, despite being aimed at achieving the same result (i.e., removing toxic waste from the patient’s bloodstream), the identified tools require that the nurse should use two entirely different set of skills. Furthermore, the two strategies are characterized by different advantages and disadvantages. For instance, hemodialysis is by far the easiest procedure out of the two, which is why the quality of the services and the patient outcomes are likely to be rather positive. However, the process is rather tiresome, and the patient is likely to feel exhausted afterward. Peritoneal dialysis, on the other hand, is significantly faster than hemodialysis, which reduces the threat of exhausting the patient. However, the risk of abdominal infections, to which peritoneal dialysis exposes the patient, clearly makes the identified approach much more dangerous.
Managing Chronic Genitourinary or Renal Disorder
Despite being a very complicated issue that needs consistent help from nurses and healthcare practitioners, chronic renal failure in itself does not require that its victim should be admitted to the environment of acute care (Vandenkerkhof, Hopman, Carley, Kuhnke, & Harrison, 2013). However, in some scenarios, patients develop the complications that require regular supervision of the healthcare experts, therefore, making it necessary to place the patient in the acute care unit. The development of an ulcer. Indeed, the oedema that the retention of water causes is likely to result in an ulcer unless attended to in an appropriate manner. As soon as the patient develops one as a result of the lack of supervision from the corresponding healthcare unit, the necessity to place them in the acute care environment emerges (Stern, Cifu, & Altkorn, 2015). The reasons for refusing to manage the problem in the outpatient setting and, instead, insisting on relocating the patient to the acute care ward are quite obvious. Because of the rapid progress of the disease, the ulcer is likely to cause even more problem unless proper care is provided. Particularly, there is a threat that the wound will progress to the point where it triggers sepsis. In the identified setting, my role as a nurse will concern assessing the effects of the medical treatment, the patient’s response to the therapy, and the management of the patient’s needs. It will be crucial to create the environment in which patients will recover faster (Vandenkerkhof et al., 2013).
Renal Abnormalities: Clinical Characteristics
There are a plethora of conditions that can be defined as renal abnormalities, and the Obstructive Renal Pelvis Defect is one of them. The phenomenon manifests itself in the retention of fluid due to the blockage of the kidney drainage system. The obstruction may be either partial or complete, yet both cases require immediate surgery. The recanalization of the outflow tract can be the reason for the problem to start developing, in the first place, yet the factors that affect the tissue and contribute to its development are numerous.
Seeing that the issue is known to be a birth defect that occurs at a genetic level, it will be reasonable to use ultrasound as the screening tool during pregnancy. Thus, the problem can be identified and addressed at the earliest stages of its development, and a range of side effects can be avoided. Particularly, to address the problem and nip it in the bud, one may need to consider vesicoureteral reflux (VUR) tests (Weitz & Schmidt, 2016). Maternal serum screening should be viewed as a necessity given the need to identify the genetic issues that may create the foundation for the development of the disease (Papadakis, McPhee, & Rabow, 2014).
The choice of the tools was predetermined by the combination of quality and speed that they had to offer. Seeing that the problem can be determined and addressed at the earliest stages of the fetus’s development, it is imperative to make sure that the patient should receive the required screening. As a result, the threat of the disease progressing to the point where it cannot possibly be managed will be reduced significantly. Furthermore, even in case the disease turns chronic, a more efficient and comprehensive treatment approach can be designed for the quality of the patient’s life to improve significantly.
References
National Institute of Diabetes and Digestive and Kidney Diseases. (2016). Peritoneal dialysis dose and adequacy. Web.
Nesrallah, G. E., Mustafa, R. A., Clark, W. F., Bass, A., Barnieh, L., Hemmelgarn, B. R.,… &, Moist, L. M. (2014). Canadian Society of Nephrology 2014 clinical practice guideline for timing the initiation of chronic dialysis. Canadian Medical Association Journal, 186(2), Canadian Medical Association Journal, 183(2), 112-117. Web.
Papadakis, M., McPhee, S. J., & Rabow, M. W. (2014). Current medical diagnosis and treatment: 2015 (54th ed.). New York, NY: McGraw-Hill.
Stern, S. D. C., Cifu, A. S., & Altkorn, D. (2015). Symptom to diagnosis: An evidence-based guide (3rd ed.). New York, NY: McGraw-Hill Education.
Vandenkerkhof, E. G., Hopman, W. M., Carley, M. E., Kuhnke, J. L., & Harrison, M. B. (2013). Leg ulcer nursing care in the community: a prospective cohort study of the symptom of pain. BMC Nursing, 12(3), 1-9. Web.
Weitz, M., & Schmidt, M. (2016). To screen or not to screen for vesicoureteral reflux in children with ureteropelvic junction obstruction: a systematic review. European Journal of Pediatrics, 176(1), 1–9. Web.