Essay on Community Nursing Support for Chronic Kidney Disease Patients

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This essay delves into the crucial role of community nurses in supporting patients with chronic kidney disease (CKD). It begins with an introduction to CKD, its causes, and its impact on patients and their families. The essay then focuses on the self-management strategies taught by community nurses, including patient education about the disease, dietary recommendations, the importance of support groups, and the use of various exercises and interventions to manage symptoms such as fatigue and breathlessness. It emphasizes health promotion, cultural safety, and empowerment, highlighting the nurse's role in guiding patients towards a healthy and productive life despite their illness. The essay also addresses the importance of time management for patients and their families, as well as the impact of the disease on the patient's career. Ultimately, the essay concludes by reiterating the nurse's essential role in providing guidance and support to help patients overcome the challenges of chronic illness and achieve a better quality of life.
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COMMUNITY NURSING
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Introduction
Chronic disease means those diseases that continues for a long time and causes a serious
burden for life on family and nation. A person suffering from the disease is depended on other
individuals for support. They, in some cases are disabled for life. The individuals suffering from
the chronic disease causes the greatest burden on nation. One such chronic disease is chronic
kidney Disease that disables a person for life. There is treatment of the disease but owing to its
seriousness, it is incurable (Mayo Clinic, 2019). It is the situation where the kidneys are damaged
and are not healthy enough to purify the blood in the body thus leading to increased wastage in
the body. If the purification of the blood is not done then it may lead to death of an individual in
some cases. Such diseases hamper the normal functioning of the person and affect their various
aspects of their life. The essay will be highlighting the self-management strategies taught by the
community nurses to patient and his family to deal with kidney chronic disease.
Community Nursing
About Chronic Kidney Disease
Chronic kidney disease means the failure of the proper functioning of the kidneys to
purify the blood of an individual thus leading to toxicity in the body. The main job of the
Kidneys is to filter water and blood from the waste in the body. It also balances the salts and
minerals content in the body. When the functions of the kidney get hampered, the waste started
getting heaped in the body leading to the spread of toxics in the body. The failed kidneys can
only be treated with dialysis or complete transplant. According to the Australian Government
report, the Chronic Kidney Disease affects one in ten adults of Australia (1.7 Million)
(Australian Governement, 2019). The disease also contributes to one in nine deaths of Australian
adults. There are major causes due to which the disease occurs in an individual. The causes are
Diabetes, heart disease, High blood pressure and family history (Heart, 2019). The long-time
affliction with the high blood pressure, diabetes and heart disease could lead to the Chronic
Kidney disease. The Chronic Kidney Disease initially causes no problems but as the condition of
the kidney exacerbates. The body started showing some symptoms. The symptoms include
fatigue, chest pain, dry skin, headaches, nausea, appetite loss, vomiting, insomnia, shortness of
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breath, and muscle cramps. The kidney disease could lead to other problems such as heart
disease and strokes (Obrador & Levin, 2019).
The diagnosis of the Chronic Kidney Disease can be done through estimated glomerular
filtration rate (EGFR), Urine test and blood pressure test. The chronic kidney disease can be
treated if diagnosed early. The treatment can be done to avoid Kidney failure that include
controlling blood Sugar, maintaining the healthy blood pressure and weight, consuming low salt
diet and limiting the intake Alcohol and smoke. If the kidneys are not treated properly then it
may cause kidney failures in a long run. The Kidney Failure can only be treated through dialysis
or kidney transplant (Brown & Brennan, 2015).
Many people think that suffering from chronic kidney disease could lead to dialysis. All
kidney diseases do not lead to dialysis. A person suffering from chronic kidney disease can lead
a productive lifestyle where a person can excel in his career and personal life by taking healthy
diet. Although the patient has full, potential to live a healthy life but managing One’s life along
with disease is not an easy task. An individual gets physically and mentally drained. The disease
sometimes creates frustration in the patient due to the increased fatigue (Lopez-Vargas & Craig,
2016). The conditions of the diseases might make individuals incapable of doing certain jobs
which require high physical labor such as the jobs in defense sector or any job which require the
high level of physical energy. The conditions of the disease might make some unfit for various
employment opportunities. Moreover, the disease causes the psychological and financial burden
on the families. It becomes a tough time for them to manage the things (Prasad - Reddy, Isaacs,
& Kantorovich, 2017).
Managing lifestyle with chronic disease
The management of the disease related symptoms becomes essential to live a normal
productive life by an individual. An individual can do the management in an effective manner, if
he has a proper knowledge of the disease. Everything related to the disease such as symptoms,
interventions to control them, a proper diet, and pharmacological ways of treating the symptoms
are taught to them (Ricardo, et al., 2016). The proper knowledge of the disease will increase the
awareness of the disease and they will be able to control the symptoms. The proper accumulation
of knowledge is not possible by the patients. It can teach them regarding the proper interventions
to control the symptoms. Various digital technologies can be used in improving their awareness
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such as power point presentations, videos, and documentaries showing the productive lives of
people who are affected by chronic kidney disease (Navaneethan, 2017). Such documentaries
can serve as the motivation to the patients of chronic kidney disease to live a successful life with
the disease.
The nurse can guide them towards a proper and healthy diet with low salt and sugar
contents. The right kind of the diet can help a person live a happy, healthy, and productive life.
The caretaker appointed for the patient can encourage them to follow the DASH diet. The
authors Narva and Boulwar writes about the importance of Dash diet as it aims to reduce the
hypertension in an individual. The dash diet consists of fruits, veggies, poultry, seeds, beans, and
low-fat dairy products. The diet is low in sodium, sweets, sugars, and red meats (Narva &
Boulware, 2016). It is also advisable to cut sodium, calcium, and phosphorous intake in diet. It is
not restricted to take fluids but if in the case the condition gets serious, the doctor can advise to
cut back on liquids (Crews, 2016).
The support groups are of great help for patients suffering from the chronic disease as it
helps in releasing the psychological stress of the patients (Bowling & Echt, 2017). As patients
get psychologically depressed when they get to know about the disease, they are suffering from.
The support group of consist of people suffering from similar diseases. The discussion with the
people regarding various experiences of symptoms would provide them with various
interventions to deal with their own (Vélez‐Vélez & Bosch, 2016). According to the authors
Tang and Posner, The community nurse can also guide the patient to do meditation, as it will
calm the chaos in their mind and helping them in easy management of their life with symptoms.
They will be in the better position to deal with the challenges that come along with the disease
(Tang & Posner, 2015).
The disease can cause prolonged fatigue in an individual so the patients could be taught
various exercises to maintain the energy level in the body. One of the symptoms that the patients
might experience in the chronic Kidney disease is the symptom of breathlessness (Almutary,
Douglas, & Bonner, 2016). The authors Clarke and Smith claim that the breathlessness can be
cured by doing various yoga asana. The nurse can guide the patients towards various asana such
as Ujjain, belly, and lion asana. Such kind of breathing exercise will help in reducing the
breathlessness in patients (Clarke & Smith, 2015). Patients might experience muscle cramps, the
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nurse can provide a good massage on the affected area. An extensive massage can solve their
problems. It is important for the nurse to be aware of the culture of the patient. In a case where a
patient is a non-vegetarian then instantly cutting out the non-vegetarian diet is not feasible (Kelly
& Strippoli, 2017). The nurse can resort to other options of serving the non-vegan diet with less
contents of protein in it for example a sandwich with thin slices of meat in it. As per the author
Devoe The nurse should also be well-versed with the history of the patient if a patient has a
smoking habit then the nurse can use nicotine replacement therapy that include nicotine patches,
inhalers and nasal spray as nicotine has a bad effect on the kidneys (Devoe, 2016). The most
important thing is educating the grieved family of the patient that the patient can live a healthy
life despite of illness. The right kind of guidance from a nurse can bring the patient’s life to
normalcy thus making it possible for him to do the impossible (Deravin-Malone & Anderson,
2016).
When a patient has a kidney problem, the patient, as well as his family, have to take care
of time management because the kidney patient needs dialysis every third day so that his family
has to manage his time accordingly to this schedule (Webster, Nagler, Morton, & Masson, 2017).
The effect of the disease is also seen on the career of a patient with kidney disease. Kidney
patients keep feeling tired and weak all the time, due to which their weakness and tiredness
affect their work, as well as the kidney patient has flu and the patient is unable to concentrate on
work (Razmaria, 2016).
Conclusion
Patients suffering from chronic disease suffer from various symptoms that affect their
lifestyle. Their productivity is hampered in all the aspects of their lives. They suffer from
prolonged fatigue that influences their relationship with people, work life and spiritual life. In
such cases, it becomes important to have the support of the nurse who can guide them towards
living a healthy, happy and productive life. They educate and guide them to achieve a
productive lifestyle despite of their chronic illness. The motivation provided by the nurse to the
patients helps them overcome all the inevitable challenges of the chronic illness. It teaches them
the means to manage the crises through appropriate use of pharmacological and non-
pharmacological symptoms.
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Reference List
Almutary, H., Douglas, C., & Bonner, A. (2016). Multidimensional symptom clusters: an
exploratory factor analysis in advanced chronic kidney disease. Journal of Advanced
Nursing, 72(10), 2389-2400.
Australian Governement. (2019, September 1). Chronic kidney disease. Retrieved September 2,
2019, from aihw: https://www.aihw.gov.au/reports-data/health-conditions-disability-
deaths/chronic-kidney-disease/overview
Bowling, C. B., & Echt, K. V. (2017). Older patients’ perspectives on managing complexity in
CKD self-management. . Clinical Journal of the American Society of Nephrology, , 635-
643.
Brown, M. A., & Brennan, F. P. (2015). CKD in elderly patients managed without dialysis:
survival, symptoms, and quality of life. . Clinical Journal of the American Society of
Nephrology, 260-268.
Clarke, A. L., & Smith, A. C. (2015). Motivations and barriers to exercise in chronic kidney
disease: a qualitative study. Nephrology Dialysis Transplantation, , 1885-1893.
Crews, D. (2016). Chronic Kidney Disease: A Place for Primary Care and Nephrology to Meet.
Journal of General Internal Medicine, 31(1), 5-6.
Deravin-Malone, L., & Anderson, J. (2016). Chronic care nursing : a framework for practice.
Melbourne: Cambridge University Press.
Devoe, D. J. (2016). Patient education and peritoneal dialysis modality selection: a systematic
review and meta-analysis. American Journal of Kidney Diseases, 422-433.
Heart. (2019, September 1). How High Blood Pressure Can Lead to Kidney Damage or Failure.
Retrieved September 3, 2019, from heart: https://www.heart.org/en/health-topics/high-
blood-pressure/health-threats-from-high-blood-pressure/how-high-blood-pressure-can-
lead-to-kidney-damage-or-failure
Kelly, J. T., & Strippoli, G. F. (2017). Healthy dietary patterns and risk of mortality and ESRD
in CKD: a meta-analysis of cohort studies. Clinical Journal of the American Society of
Nephrology, 272-279.
Lopez-Vargas, P. A., & Craig, J. C. (2016). Educational interventions for patients with CKD: a
systematic review. American Journal of Kidney Diseases, 353-370.
Mayo Clinic. (2019, September 1). Chronic kidney disease. Retrieved from mayoclinic:
https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/diagnosis-
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treatment/drc-20354527
Narva, A. S., & Boulware, L. E. (2016). Educating patients about CKD: the path to self-
management and patient-centered care. Clinical Journal of the American Society of
Nephrology, , 694-703.
Navaneethan, S. D. (2017). Pragmatic randomized, controlled trial of patient navigators and
enhanced personal health records in CKD. . Clinical Journal of the American Society of
Nephrology,, 1418-1427.
Obrador, G. T., & Levin, A. (2019). Introduction: CKD hotspots. Elsevier, 227-229.
Prasad - Reddy, L., Isaacs, D., & Kantorovich, A. (2017). Considerations and controversies in
managing chronic kidney disease: An update. American Journal of Health-System
Pharmacy, 74(11), 795-810.
Razmaria, A. (2016). Chronic Kidney Disease. JAMA, 315(20), 2248.
Ricardo, A., Roy, J., Tao, K., Alper, A., Chen, J., Drawz, P., . . . Fischer, M. (2016). Influence of
Nephrologist Care on Management and Outcomes in Adults with Chronic Kidney
Disease. Journal of General Internal Medicine, 31(1), 22-29.
Tang, Y. Y., & Posner, M. I. (2015). The neuroscience of mindfulness meditation. Nature
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Vélez‐Vélez, E., & Bosch, R. J. (2016). Illness perception, coping and adherence to treatment
among patients with chronic kidney disease. Journal of Advanced Nursing, 72(4), 849-
863.
Webster, A. C., Nagler, E. V., Morton, R. L., & Masson, P. (2017). Chronic Kidney Disease.
The Lancet, 389(10075), 1238-1252.
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