NURBN2016 - Nursing - Melanie Johnson Case Study Assessment Answer

NURBN2016 - Nursing - Melanie Johnson Case Study Assessment Answer

Task:

Melanie Johnson is a 55-year-old, mother of 5 kids and lives in a rural Victorian town. She married Frank who is an electrician, for 18 years. They live on a farm, tending to be self- sufficient growing their veggies, some fruit and have chicken and cows. Their five kids are aged between 10 and 15 years. Melanie does home-schooling for all her kids. She got concerned with her feeling of increasing tiredness, nausea and general pruritus. She told Frank that it was not just related to her menopause but she suspects it to be something more serious.
She visited her GP, who found her BP to be 190/110mm Hg. Although she is not diagnosed with hypertension, she admitted getting severe headaches and sometimes palpitations for over 5 years, when she was worried about the drought. She has been taking Ibuprofen and naproxen for the headaches over nearly 12 years but did not seek medical help as they would settle. Further, she was referred to a nephrologist and was diagnosed with chronic renal failure. After reviewing her blood results below, Melanie has been advised to undergo renal replacement therapy (Haemodialysis) after creating an arteriovenous fistula (AV fistula)
Her blood results were:
GFR (glomerular filtration rate) was found to be 10ml/min/1.73m2
Hb (Haemoglobin) was 95g/L
Serum Potassium was 5.7 mmol/L
Serum Urea 17 mmol/L
Serum Creatinine 90 umol/L

Part-1 -NURBN2016,
1.1 Briefly describe the renal anatomy and physiology
1.2 Discuss the pathophysiology of chronic renal failure in Melanie, including her risk factor(s), possible complications and treatment options
1.3. Identify at least 6 differences between Acute and Chronic renal failure.
1.4. Discuss renal replacement therapy (haemodialysis) with clear links to Melanie’s case.

Part - 2 - NURBN2016,
Melanie has been commenced on tablet valsartan 80 mg OD and injection Eprex 50 IU/kg iv three times/week, apart from other drugs.
2.1 Discuss the two medications used for Melanie, with rationale and clear links to her case. Include 4 major side effects and 4 nursing considerations relevant to Melanie for each drug.
2.2 Discuss the GFR and Hb blood test performed for Melanie. What do her results indicate (GFR and Hb only)?

Part - 3 -  NURBN2016,

3. Melanie asks how she can manage her chronic renal failure.
- Discuss what the teach-back method is? (100 words).
- Using the teach-back method, discuss how you would educate Melanie to manage her fluid intake in relation to her diet.

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