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** please comments to peers DQs response separately add citations and references 🙂 *****
Response one: Many disease factors can affect an individual’s elimination processes, which include the renal, pancreatic, hepatic, biliary, and gastrointestinal systems (Grand Canyon University, 2018). Elimination complexities can affect the lives of patients and families in numerous ways because of the limited choices they have due to their diagnoses, such as renal failure, pancreatitis, and cancer. Nurses need to provide care that is specific to the individual’s needs. The nurse plays a vital role in terms of management of elimination complexities upon the initial presentation, during treatment, and upon discharge (Grand Canyon University, 2018). Patients and their families will need support and education about their disease process.
For example, with End-Stage Renal Disease, there is a limited treatment, which includes the options of a kidney transplant, dialysis, and supportive care. Unfortunately, many patients are not eligible for a kidney transplant due to multiple other prognoses’ such as diabetes. Therefore, dialysis is the only plausible option. Hemodialysis is often scheduled three times per week and lasts for 3-5 hours. Every individual copes with difficult times in different ways, and the first few months may be the hardest because of the fear and uneasiness, but it is a life-saving treatment. People who have end-stage renal disease must be educated about fluid restrictions, dietary restrictions, and healthy eating, and adjust to their new life with dialysis because of the time they spend at the dialysis center and feeling exhausted afterward. Dialysis can take a toll on the patient, and it is important to encourage patients and include their families for support. The nurse’s role is to be supportive of the patient and their families and therapeutically address their needs. The nurse must educate the patient and their families about how kidney disease will affect the patient physically, emotionally, and even financially. Nurses are the main people who provide care for the patients affected by End-Stage Renal Disease, and it is the role of the nurse to identify what care needs to be provided for their patients to reduce their fears, support their decisions, provide emotional support, and education (Shahdadi, Rahnama, 2018).
Grand Canyon University (Ed). (2018). Pathophysiology: Clinical applications for client health. Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/
Shahdadi, H., & Rahnama, M. (2018). Experience of Nurses in Hemodialysis Care: A Phenomenological Study. Journal of clinical medicine, 7(2), 30. DOI:10.3390/jcm7020030
Response two: Elimination complexities in the renal, pancreatic, hepatic, biliary, and gastrointestinal tract can lead to acute and chronic conditions. In the renal system the failure “affects all body systems and can cause hyperkalemia, hypervolemia, peripheral edema, anemia, hyperphosphatemia, hypocalcaemia, axotemia, metabolic acidosis, and peripheral neuropathy” (Whitney, S., 2018). The pancreatic complexities include severe pain associated with pancreatitis, elevated serum amylase; lipase levels, and elevated liver function. Cirrhosis of the liver causes the liver to fail; symptoms include jaundice, edema, ascities, and blood clotting. Gallbladder dysfunctions can be caused by inflammation and obstruction and be very painful. The gastrointestinal tract starts and the mouth and ends at the anus, there are a multitude of disorders along this system. “The most valuable nursing intervention is encouraging resiliency” or “the capacity of individuals to successfully maintain or regain their mental health in the face of significant adversity or risk” (Whitney, S., 2018). This can enhance the patients’ quality of life as many of these conditions are irreversible or causes end-stage disease. Referring the patient to support groups specicific to their disease process, allowing the patient to process the information regarding diagnosis, treatment, and prognosis. “Providing patient education is an important part of transitioning the patient from acute or chronic illnesses to independence, lack of education can cause anxiety for some patients and their family members” (Whitney, S., 2018).
Whitney, S. (2018). Elimination Complexities. Pathophysiology Clinical Applications for Client Health. Retrieved from
Response three: There are numerous elimination complexities that can effect the patient’s life, such as renal, pancreatic and hepatic problems and dysfunction. As an ER nurse, the one problem that appears to have the most impact on the patient’s quality of life is renal failure that leads to the need for dialysis. Patient’s who are in dialysis need careful and intense management, and compliance is so important. Patient’s who skip dialysis either due to transportation issues, schedule conflicts or depression end up in the ER with severe SOB, hypertension and activity intolerance and sometimes altered mental status. Patient’s in chronic renal failure also often need blood transfusions during dialysis so careful lab monitoring is crucial. It is important that resources be available to these patients such as transportation, home health and counseling and education for both them and their family members. Family members call be called on to assist with the management of this disease. Dialysis is very hard on the patient and their family so nurses need to do what they can to reduce the burden that is placed on these people by offering emotional support as well.
Patients who have Grand Canyon University (Ed). (2018). Pathophysiology: Clinical applications for client health. Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-cl…