Medical Surgical Nursing

This document discusses the importance of fluid assessment and cardiovascular assessment in medical surgical nursing. It also emphasizes the significance of patient education in managing renal kidney failure.

Running head: MEDICAL SURGICAL NURSING
Medical Surgical Nursing
Name
Institutional Affiliation

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Medical Surgical Nursing
Task One
Fluid Assessment
Fluid balance is essential in the normal functioning as it helps in balancing the
concentration of salts, blood, and body temperature. Fluid assessments help determine the direct
cause of the disorder (Godin Bouchard & Mehta, 2014). However, when a person suffers acute
kidney injury (AKI) like the case of Mr. Haynes, there is a need for fluid assessment to
determine fluid accumulation and make possible early intervention. The purpose of fluid
assessment is to determine if there is any fluid accumulation and make informed decision on
therapy that could help the patient. I will carry out fluid assessment by monitoring the blood
volume. Zhu, Rosales, and Kotanko (2016) explain that the goal of the relative blood volume is
to determine intradialytic changes in blood volume. If fluid accumulation is indicated, Ding,
Cheng, and Qian (2017) recommend that the patient is exposed to renal replacement therapy,
fluid management therapy, or diuretics.
Cardiovascular Assessment (Bp and Pulse)
Cardiovascular diseases are linked to damage to the kidney, but kidney injuries also have
direct impact to the heart and can cause heart diseases. According to Bharti et al. (2016), kidney
injury leads to accumulation of fluid in the kidney. To get rid of the fluid, the heart is forced to
use extra force which increases blood pressure and pulse. Since Mr. Haynes has kidney injury, I
will carry out cardiovascular assessment (both blood pressure and pulse) to determine the
functioning of the heart. Harty (2014) explains that pulse assessment will help determine
whether kidney injury has an impact to the heart. When carrying out BP and pulse assessment, I

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will use the blood pressure cuff and place it at the upper side of the arm. I will take and record
the readings. An indication of a higher Bp and pulse indicates that the kidney injury has affected
the heart.
Task 2: Patient Education
One of the best interventions in managing renal kidney failure is to train the patient on
food intake and the specific foods to avoid. Patient education is one of the preferable process in
self-management and improvement in outcomes in management of kidney disorders (Moore,
Hsu, & Liu 2018). According to Shah et al. (2015), kidney impairs the functioning of the
kidney by causing the accumulation of salts which are supposed to be discharged regularly.
Other dietary changes and monitoring include intake of foods rich in cholesterol, potassium,
phosphate, and protein. As a result, there is a need to train Mr. Haynes on how to manage the
condition by preventing further damage to the glomerular filtrate rate. Patient education should
take into consideration lifestyle changes and use of medication to improve his health and attract
positive health outcomes.
Educating Mr. Haynes on managing the renal condition has significant advantages. One
of the advantages is that it shifts the responsibility of managing the disorder from the caregiver
to the patient. Additionally, during education, the patient will have all the questions and
concerns addressed. This could make the patient make informed decisions, especially
considering that Mr. Haynes has been drinking five times a week (Hertzberg et al., 2017).).
When Mr. Haynes has understood the impact of his lifestyle on the kidney and how he endangers
the remaining lifespan of the organ, he may end up quitting drinking and eventually lead a better
life because he is aware about the risks associated with poor choices on his health. A study

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carried out by Narva, Norton, and Boulware (2016) found that management of chronic kidney
diseases in patients with knowledge yielded improved outcomes and improved the quality of life
compared to the group that did not have knowledge about managing the disease.
Patient education helps in shared decision making between the patient and the caregiver.
For instance, Adriana et al. (2016) explain further that patients with renal kidney failure need
enough rest at night to avoid being fatigued. They are also supposed to move around to avoid
clotting of blood in their bodies. Mr. Haynes will also require to take medication as instructed if
he is determined to improve the quality of his life. Such information is only important when we
share the information with the patient and discuss the possible positive outcomes from the
treatment program. For the case of Mr. Haynes, he needs sufficient information to make
decisions about his drinking and smoking habits. When he is provided with sufficient
information about the cause of his current condition, he will make up his mind and take the path
to recovery. Considering that Mr. Haynes lives alone and the wife is away, there is a need to
involve the family in decision making and make them aware of their patient. Patient awareness
will reduce the risk of further damage to the kidney. This could help the wife move and live
close to the husband to help in monitoring his life and yield positive outcomes in the treatment
process.

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References
Adriana et al. (2016). Baseline pulse pressure, acute kidney injury, and mortality after non-
cardiac surgery. Anesthesia & Analgesia, 123 (6), 1480–1489. Retrieved from
https://journals.lww.com/anesthesia-analgesia/FullText/2016/12000/
Baseline_Pulse_Pressure,_Acute_Kidney_Injury,_and.20.aspx
Bharti et al. (2016). Diagnosis and management of cardiovascular disease in advanced and end
stage renal disease. Journal of the American Heart Association. Retrieved from
https://www.ahajournals.org/doi/10.1161/JAHA.116.003648
Ding X., Cheng Z., & Qian, Q. (2017). Intravenous fluids and acute kidney injury. Karger,
43(3). Retrieved from https://www.karger.com/Article/Fulltext/452702
Godin M., Bouchard J., & Mehta R., L. (2014). Fluid balance in patients with acute kidney
injury: emerging concepts. Karger, 123(4). Retrieved from
https://www.karger.com/Article/FullText/354713
Harty J. (2014). Prevention and management of acute kidney injury. The Ulster medical journal,
83(3), 149–157. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255835/
Hertzberg, D., Rydén, L., Pickering, J. W., Sartipy, U., & Holzmann, M. J. (2017). Acute
kidney injury-an overview of diagnostic methods and clinical management. Clinical
kidney journal, 10(3), 323–331. doi:10.1093/ckj/sfx003. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466115/

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Moore, P., K., Hsu, R., K., & Liu, K. (2018). Management of acutekidney injury. American
Journal of Kidney, Disorders. Retrieved from https://www.ajkd.org/article/S0272-
6386(17)31141-1/pdf
Narva, S., Norton, J., N., & Boulware, E. (2016). Educating patients about CKD: The path to
self-management and patient-centered care. CJASN, 11 (4) 694-703, DOI:
https://doi.org/10.2215/CJN.07680715. Retrieved from
https://cjasn.asnjournals.org/content/11/4/694
Shah, S. R., Tunio, S. A., Arshad, M. H., Moazzam, Z., Noorani, K., Feroze, A. M & Jeoffrey,
S. A. (2015). Acute kidney injury recognition and management: a review of the literature
and current evidence. Global journal of health science, 8(5), 120–124.
doi:10.5539/gjhs.v8n5p120. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4877204/
Zhu, F., Rosales, L.,& Kotanko, P. (2016). Techniques for assessing fluids status in patients
with kidney disease. Current Opinion in Nephrology & Hypertension 25(6). Retrieved
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