Diagnosis and Treatment Modalities (PDF)

CONCEPT MAP

TABLE OF CONTENTS
1. Patient’s risk factors.................................................................................................................1
2. Disease’s/disorder’s pathophysiology manifests to produce all the patient’s clinical
manifestations..............................................................................................................................1
3. Diagnosis and treatment modalities.........................................................................................2
REFERENCES................................................................................................................................3

1. Patient’s risk factors
There are various kinds of risk factors associated with Chronic kidney disease what is
found within diabetes patients. Risk factors associated with the patient disease are: type II
diabetes can lead to hypertension or high blood pressure (Hill & et.al., (2016). If it is not
controlled then it can also increase the overall weight of a person as well. This can further lead to
worsened fatigued and itchy skin. Hypertension can increase risk factors such as increase weight
of the patient and become obese. Increased blood pressure can worsen a patient's type two
diabetes and can further lead to serious chronic kidney disease. It can either worsen kidney
functioning or can damage kidney permanently.
It has been observed that most of the kidney diseases are caused due to diabetes and
increased blood pressure. Both of them together can damage the kidney in several ways and can
lead to diffusion of nephron loss within the patient (Webster & et.al., 2017). It is extremely
important to reduce risk of kidney disease because if it is not done then it can further increase
other risk factors such as: cholesterol of an individual can increase, increase chances of kidney
infection or kidney stones can swollen body parts, increase hypokalemia and metabolic acidosis
as well. One of the biggest risk associated with chronic kidney disease is development of
hypokalemia. It reduces the overall potassium level of the body which is extremely important for
body, especially for heart. This many times further leads to metabolic acidosis.
2. Disease’s/disorder’s pathophysiology manifests to produce all the patient’s clinical
manifestations
Diabetes is one of the most crucial epidemic that can further lead to chronic kidney
disease. Chronic kidney disease mainly occurs due to renal insufficiency which may further
change to renal failure (Di Lullo & et.al., 2015). In order to diagnose Chronic kidney disease it is
important that kidney functionalities to decline for more than three months and evidence of
kidney failure should be present only then kidney disease can be diagnosed. Deterioration of
Kidney due to Chronic kidney disease is mostly seen in diabetic patients. Aggressive increase of
blood sugar level can lead to hypertension, which becomes the main reason for chronic kidney
disease.
Patients of Chronic kidney disease (CKD) are generally asymptomatic, metabolic
derangements are not clinically evident. The disturbance manifest is clinically seen in CKD is
seen in few stages. One of the main symptom is swelling. This swelling can be because of
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various reasons. In this case study Steve had noticed swelling in his legs (Hruska, Seifert &
Sugatani, 2015). Another symptom is fatigue and itchy skin. This fatigue is mainly due to renal
failure or due to renal insufficiency. Next symptom is diagnosis of Hyperkalemia. This mainly
occurs due to inability of kidney to secrete potassium which can lead to metabolic acidosis. this
the main pathophysiology manifests of Chronic kidney disease that leads to produce clinical
manifestations.
3. Diagnosis and treatment modalities
The patient has been suffering from type 2 diabetes which is not managed properly. Thus,
obesity and high blood pressure remains to be continues to be major concern for the health.
According to Hill & et.al., (2016) due to improper diabetic care skin itching, leg swelling and
oedema are quite common. In the given case study also skin disintegration, obesity and
worsening fatigue indicates the excessive damage to filtering unit within kidney due to high
sugar level. The dysfunctionality in the renal functions are also demonstrated by the diagnosis of
metabolic acidosis and hyperkalaemia.
As per the view of Webster, A. C. & et.al., (2017) the best intervention to slower the
progression of renal failure is to manage diabetes. Steve McManual must manage his weight and
diabetes so that oedema and other skin issues can be cured and excessive burden on kidney due
to higher sugar level can be avoided. The patient can be provided with tablets of NaHCO3 as part
of alkaline therapy so that excessive acid can be secreted out of body. Drugs such as insulin,
albuterol, diuretics and NaHCO3 are used so that potassium levels can be controlled. Another
treatment strategy which can be used by the nurses is to regularly monitor the sugar level,
weight, blood pressure and skin of the patient so that progression of chronic kidney failure can
be traced and quick measures can be taken to improve the condition of patient. In case of renal
failure patient may require performing dialysis or kidney transplantation thus proper care and
monitoring must be assured.
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REFERENCES
Books and Journals
Di Lullo, L., & et.al., (2015). Left ventricular hypertrophy in chronic kidney disease patients:
from pathophysiology to treatment. Cardiorenal medicine. 5(4). 254-266.
Hill, N. R., & et.al., (2016). Global prevalence of chronic kidney disease–a systematic review
and meta-analysis. PloS one. 11(7). e0158765.
Hruska, K. A., Seifert, M., & Sugatani, T. (2015). Pathophysiology of the Chronic Kidney
Disease–Mineral Bone Disorder (CKD-MBD). Current opinion in nephrology and
hypertension. 24(4). 303.
Webster, A. C. & et.al., (2017). Chronic kidney disease. The lancet. 389(10075). 1238-1252.
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