On 1/9/18 I met Ms. Hendrick at the office of Dr. Kala, Neurologist. Ms. Hendrick reports that she had just left the lab having a repeat kidney function lab value drawn. She will find out when the values are available if she is able to have the port removed from her chest and confirm that she is not going to need more dialysis. Ms. Hendrick said she has a constant headache now. Her face still becomes numb on the right and the pain is mainly on the right side of her head. The best the pain level gets is a 5 and the worst is an 8. Now that she is limited to medications she doesn’t seem to be able to break the cycle. She reports that the Sumatriptan was not approved so she did not have that to take. Ms. Hendrick also gave me a bill that was from an MRI done ordered by Dr. Saper. I have enclosed a copy for the adjuster. All medications were reviewed; many have been stopped due to the kidney function. She no longer takes Neurontin, Lyrica, and Metformin. She will need approval by the Nephrologists before she can resume them. She does however still need the Sumatriptan injections. At this point, Dr. Kala recommends getting clearance from the Nephrologists to resume treatment with Dr. Saper. Ms. Hendrick will proceed with getting that clearance. …show more content…
Hendrick. The med-port is being removed. She has not had any dialysis since 12/20/17. Her Nephrologists has determined she can have the port removed and will not need dialysis at this point. I have discussed with her moving forward in getting an appointment with Dr. Saper's office. She is very hesitant in proceeding forward and taking “experimental” medications after everything she has been through. She wants to think about it before proceeding. Dr. Kala told her she would need documentation from the Nephrologists for Dr. Saper saying it is okay to
Glomerulonephritis, as a defined disease, is very broad in terms of a medical condition and is usually only diagnosed after a routine medical check-up or tests for another condition discover; the symptoms may not be obvious. This disease targets the membrane tissues made of tiny filtering cluster units within the kidneys called glomerulus, which comes from a Greek word meaning filter (NIH, 2014). This illness presents as an inflammation of the tiny filtering units called glomeruli of the kidneys that can be caused by a passing illness associated with an infection or as a result of an autoimmune disease (Nemours, 1995-2016). Glomerulonephritis is a multi-symptom disease caused by genetics or environmental factors that can have variable degrees
Ms. Bardsley functions as a hemodialysis liaison and leader in clinical practice with the following roles: charge nurse, preceptor, and mentor for her colleagues. She is the resource person for the Hct-Line monitoring tool. The tool is used to monitor patient’s fluid removal during treatment to avoid hypotensive episodes associated with decreased perfusion to the heart. She routinely monitors the patient outcomes which to date has resulted in 0 admissions. She recently updated the policy to make it more user friendly for the staff and to maintain staff competency.
In 1954, the first organ transplant was conducted successfully in the United States. (Clemmons, 2009) Nowadays, the technology of organ transplant has greatly advanced and operations are carried out every day around the world. According to current system, organ sales are strictly prohibited in the United States. (Clemmons, 2009) However, the donor waiting list in the United States has doubled in the last decade and the average waiting time for a kidney is also increasing. (Clemmons, 2009) In the year 2007, over 70,000 patients were on the waiting list for a kidney and nearly 4500 of them died during the waiting period. In contrast to the increasing demand for kidney, organ donation has been in a decrease. (Wolfe, Merion, Roys, & Port, 2009) Even the government puts in great effot to increase donation incentives, the gap between supply and demand of organs still widens. In addition, the technology of therapeutic cloning is still not mature and many obstacles are met by scientists. (Clemmons, 2009) Hence, it is clear that a government regulated kidney market with clear legislation and quality control is the best solution to solve the kidney shortage problem since it improves the lives of both vendors and patients.
J.P., a 58 year old female, presents to the Emergency Room on March 18th. She has a past medical history of cervical cancer, atheroembolism of the left lower extremity, fistula of the vagina, peripheral vascular disease, neuropathy, glaucoma, GERD, depression, hypertension, chronic kidney disease, and sickle cell anemia. She complains of right lower extremity pain accompanied by fatigue, a decreased appetite, increased work of breathing, burning on urination, and decreased urine output for three days.
After further multidisciplinary team meetings with the involvement of John the treatment option of automated peritoneal dialysis was implemented (NSF 2004). Once the Tenchkoff catheter had been inserted, education and training completed John was ready for discharge home.
Because I provide the surgeon with medications, hemostatic agents and irrigation solutions it is crucial to know the proper usage of each, along with the side effects, patient's allergies, and contradictions of certain medications and their reactive
Health Care workers are constantly faced with legal and ethical issues every day during the course of their work. It is important that the health care workers have a clear understanding of these legal and ethical issues that they will face (1). In the case study analysed key legal and ethical issues arise during the initial decision-making of the incident, when the second ambulance crew arrived, throughout the treatment and during the transfer of patient to the hospital. The ethical issues in this case can be described as what the paramedic believes is the right thing to do for the patient and the legal issues control what the law describes that the paramedic should do in this situation (2, 3). It is therefore important that paramedics also
I was able to change central line sterile dressing and hung IV normal saline my preceptor gave me a good complement. In lab we practice IV and helped me to perform with confidence. I helped with monthly recapping.
This 70-year-old patient who presented after what appeared to be a syncopal episode. According to her grandson the patient had a change in mental status at home she was cooking, felt dizzy, went down to sit down and slumped over. It was estimated that she was out with loss of consciousness for about 15 minutes. She was subquently brought to the emergency room. When she did awake she was somewhat confused. She has a prior history of a stroke in 2014, dyslipidemia and hypertension. Initial evaluation her blood pressure was 135/96. Her heart rate was 60. Her EKG had sinus rhythm with no significant abnormalities. Her CT of her head showed no acute mass or infarct. There was also suspicion of urinary tract infection and the patient was
Traditional hemodialysis (HD) is provided to the patient at an outpatient clinic that is often referred to as a chronic unit. Patients must come to the chronic unit to be hooked up to the dialysis machine which circulates their blood through a dialyzer thereby removing toxins and excess fluid. This dialyzer is a clear plastic tube which contains thousands of micro fibers that allow the blood to flow through while enabling diffusion to remove the unwanted components of the blood. The majority of dialysis patients use this as their primary method of treatment; however, some patients find the treatment to be harsh and uncomfortable. These patients often look for alternate treatments such as peritoneal dialysis.
The nephron produces urine by removing excess water, waste, and other substances from the blood. The nephron also returns substances such as sodium, potassium or phosphorus whenever any of the substances run low. There are about one million nephrons in each kidney.
blocked has now shut down. This kidney, if left untreated for just a few days,
The cost of Medical equipment plays a significant role in the delivery of health care. The clinical engineering at Victoria Hospital is an important branch of the hospital team management that are working to strategies ways to improve quality of service and lower cost repairs of equipments. The team members from Biomedical and maintenance engineering’s roles are to ensure utilization of quality equipments such as endoscope and minimize length of repair time. All these issues are a major influence in the hospital’s project cost. For example, Victory hospital, which is located in Canada, is in the process of evaluating different options to decrease cost of its endoscope repair. This equipment is use in the endoscopy department for gastroenterological and surgical procedures. In 1993, 2,500 cases where approximately performed and extensive maintenance of the equipment where needed before and after each of those cases. Despite the appropriate care of the scope, repair requirement where still needed. The total cost of repair that year was $60,000 and the repair services where done by an original equipment manufacturers in Ontario.
From the results of the numerous tests carried out according to the patient history of frothy urine with a significant oedema over a maximum period of 5 days, the patient was diagnosed with Nephrotic Syndrome. This is condition that occurs due to leakage in the kidney filtration part leading to a large amount of protein leaking from the blood into the urine. This is mainly due to fluid retention known as oedema which is as a result of low protein level in the blood. It occurs due to abnormal functioning or a part of the kidney is affected (glomeruli). This syndrome can be caused by numerous diseases coming together to cause or form one particular disease; these causes range from minimal change disease, membranous nephropathy, focal segmental glomerulosclerosis (FSGS) and other conditions, disorders of the glomeruli. The membranous nephropathy also known as the membranous nephritis or membranous glomerulonephritis, only causes diseases in adults and very uncommon in children. Leakage occurs from this due to the thickening of the membranous in the glomeruli which is the filter of the glomeruli. Focal segmental glomerulosclerosis is a causative due to the formation of small scars (sclerosis) on some of the kidney glomeruli. Another form of cause of nephrotic is minimal change which is due to lack of virtual change detected in the glomeruli when examined under the microscope. This causes the syndrome in 9 out of a total of 10 children under the age of 5 years.
To enable me to use this situation for my reflection the patient will be referred to as "Ann". This is in order that her real name is protected and that confidentially maintained in line with the NMC (2002) Code of Professional Conduct.