Running head: TEACHING PTITLE
Mr. Howard Bernese is a 77-year-old male that was admitted to the hospital by his wife after reporting an abnormal amount of swelling in his legs and ankles. Mr. Bernese’s wife reported that the patient has also has episodes of confusion. He was diagnosed with acute kidney failure upon assessment and will need to be monitored for a few days in the hospital prior to discharge.
The patient is 6”4” and weighs 260 pounds, he lives at home with his wife who seems to manage well for her age. Due to the pandemic the patient has been to skeptical and afraid of leaving the house. Because of his fear he did not go to the urgent care when he first noticed the swelling in his lower extremities. He reports having a heart attack five years ago and a decrease in urine output. Mr. Bernese also reports taking 1000mg of ibuprofen a day for the pain in his legs. In the last few weeks, he reports feeling exhausted after standing for too long and shortness of breath from walking from one part of the house to the other. Mr. Bernese does not have the best nutrition as they order food every day due to their lack of motivation to cook. (MER, 2020)
Howard is surprised to find that the swelling in his leg is due to a very serious disease that if left untreated could result in death. The physician has ordered a dietician, strict intake and output, renal ultrasonography, and a lab on serum creatinine levels. A social worker has been assigned to Mr. Bernese to help with any difficulties the couple may experience one Mr. Bernese is discharged from the hospital. Patient will also be sent home with a health pamphlet on what foods to stay away from and what foods the patient should be eating instead. The patient will learn the severity of his condition and will be taught on the importance of immediately reporting any abnormal findings in the patient’s health.
The patient will be on a treatment to manage the amount of fluid in the client’s blood.And patient will be put on medications to control his potassium levels and medications to restore the client’s calcium levels. Dialysis treatment will be considered after several other treatments have been used. The education to the patient for the medications will be provided for both the potassium and the calcium medications. This patient has a bachelor’s in business administration and is able to speak both English and Spanish fluently which means the patient is able to understand and comprehend instructions well. Mr. Bernese concentrates best after a meal and when he is not feeling any anxiety. The patient relies on his wife’s support for comfort (MC, 2020).
Howard prefers to visually learn things rather than any other style. Says that he much rather watch television than to read a book. He enjoys instructions with photographs rather than having to read a set of instructions. He expresses the fact that he can become easily agitated if something is not easily understood and that his wife does not speak great English. The appropriate learning style for this client would be visual learning styles with minimal wording for the client to understand best.
This client should be provided education on his current illness and all the illnesses that could be caused if the patient does not take the right steps forward to a healthier life style. The patient will be taught the education on each medication he will be prescribed. Patient will be educated on how to take each medication, the frequency, the route, and the length of his medication (MER, 2020). And patient will be taught the importance of his diet and what type of diet he should follow. Due to the BMI of this patient he should be put on a high-fiber low sodium diet to prevent any other complications to occur.
If the patient is compliant with the following standards and health practices that have been in put in place for him the patient should expect to feel less pain and less swelling to be prominent in his daily life. Through the encouragement of a routine exercise plan and a meal plan given by the dietitian the patient can help to prevent further complications with his health. To prevent the patient from fluid accumulating in his body the patient should follow the diet plan set for him, the patient is eager to do so. Based on a scholarly article a low sodium diet can help to prevent fluid from accumulating in the patients body (MC, 2020).
1. Make a diet plan with foods that are enjoyable for the client
2. Encourage the patient to stay away from food that are high in sodium
3. Encourage patient to follow a high-fiber diet
4. Find a CKD support group that the patient can attend to provide support for his new life change
5. Exercise at least 30 minutes daily
6. Follow directions given by the nurse regarding the medications
7. Increase movement throughout daily life
8. Follow up with PCP every month to check labs
9. Report any pain or any swelling to PCP right away
10. Report any adverse effect of medication to patient right away
11. Give proper education to both the patient and the spouse of the patient
Time and Resources
Howard Bernese needs to be evaluated regularly to assure that the care plan that was provided for the patient is effective for his health. The patient needs to be educated on medications and overdose. If the patient is experiencing pain the pain should be taught the cautions of overdosing and to not take more medication that what is prescribed to him. Within 5 months the patients levels will be stabilized if he follows the care plan that is set out for him. The patient will be given different support groups that are available to him that could help with his new life changes. A go fund me will be set up by his niece in order to compensate for this unexpected health situation. Mr. Bernese will follow his exercise routine. (MC, 2020) If the patient request further education the proper information should be provided to the patient.
Patient was evaluated by primary care physician every month but an entire assessment was done four months after the diagnosis of acute kidney disease. Lab results are normal and in range. The patient has done well with following medications, the right diet plan, and has exercised daily. The patient has lost 10lbs while on this new diet and the swelling is no longer visible. Pitting edema of +2. The wife has also taken part in the same diet plan and exercise routine in order to make the transition for the patient easier. He has been to support groups that have helped him with this new change in his life. The patient is currently taking kayexalate and calcitonin (MER, 2020)
Mayo Foundation for Medical Education and Research. (2020, July 23). Acute kidney failure. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/kidney-failure/diagnosis-treatment/drc-20369053.
Mayo Foundation for Medical Education and Research. (2020, March 31). Medications for Acute Kidney Disease. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hypercalcemia/diagnosis-treatment/drc-20355528.