LEARNING LOG         19/04/2024

 

 RENAL PATIENTS.                

 

The lesson started with an introduction of the module with the learning objectives.  We looked at the anatomy and physiology of the renal system. I learnt that all the oxygenated bloods are connected to the Venal Cavity.  

The right artery carries oxygenated blood to the kidney, while the right ventricle carries blood to the heart and  the kidney is situated between T12 and L 3.

 

The following are the functions of the kidney:

• To eliminate waste and excess fluid.
• For reabsorption
• To control BP
• To maintain haemoglobin (low HB)
• Signals to produce red blood cells.

We say the nephron is the functional unit of the kidney. The function of the nephron is as follows:

• Glomerular Filtration Rate (GFR) 

Normal = 90 – 120

            Abnormal = 15 – 30

            Early abnormality = 60 – 90

• Tubular Reabsorption
• Tubular Secretion.

 

I learnt that crantin is the main blood test carried out to prove the weakness of the kidney.

 

Acute kidney injury (AKI) is an abrupt disease in the kidney function that compromises  both injury (structural damage) and impairment (loss of function).

 

AKI is often a complication of another illness (10 – 15% of hospital admission).

Deterioration in renal function leads to the accumulation of waste products on the body.

This can lead to permanent injury to kidneys and sometimes DEATH.( 25 – 30% impatient mortality rate).

I learnt that patients with renal failure should not take anything with potassium (banana, spinach, avocado to name but a few). Medications like spironolactone, furosemide to name but a few. Meds to reduce potassium levels are insulin, sodium sulphate, salbutamol……

 

             These are some of the causes of AKI, and there are three different groups namely:

 

• Pre-renal – inadequate perfusion. Not enough blood at sufficient pressure to allow filtering.
• Renal – Cellular damage/intrinsic. Damage to the cells that make filtering mechanism possible
• Post -renal- obstruction. Urine unable to drain adequately-system back up.

 

                                                                 KSB ADDRESSED.

 

K1: Understand the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and how to fulfill all registration requirements 

K4: Understand the principles of research and how research findings are used to inform evidence-based practice 

K6: Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice 

K8: Understand how discriminatory behaviour is exhibited 

K11: Understand the factors that may lead to inequalities in health outcomes 

K12: Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and well-being 

K15: Understand human development from conception to death, to enable delivery of person-centred safe and effective care 

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care 

K17: Understand commonly encountered mental, physical, behavioural and cognitive health conditions as applied to delivery of care 

K18: Understand and apply the principles and processes for making reasonable adjustments 

K19: Know how and when to escalate to the appropriate professional for expert help and advice 

K20: Know how people’s needs for safety, dignity, privacy, comfort and sleep can be met 

K21: Understand co-morbidities and the demands of meeting people’s holistic needs when prioritising care 

K22: Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health 

K23: Know how to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity 

K24: Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain 

K25: Know how to deliver sensitive and compassionate end of life care to support people to plan for their end of life 

K26: Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld 

K27: Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies 

K28: Understand the effects of medicines, allergies, drug sensitivity, side effects, contraindications and adverse reactions 

K29: Understand the different ways by which medicines can be prescribed 

K30: Understand the principles of health and safety legislation and regulations and maintain safe work and care environments 

K32: Understand what constitutes a near miss, a serious adverse event, a critical incident and a major incident.

K35: Understand own role and the roles of all other staff at different levels of experience and seniority in the event of a major incident. 

K36: Understand the roles of the different providers of health and care.

K37: Understand the challenges of providing safe nursing care for people with complex co-morbidities and complex care needs. 

K40: Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings or services. 

K41: Know the roles, responsibilities and scope of practice of different members of the nursing and interdisciplinary team, and own role within it. 

K43: Understand the influence of policy and political drivers that impact health and care provision Skills.

 

                                                  SKILLS.

 

S1: Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (NMC, 2018), and fulfil all registration requirements.

S2: Keep complete, clear, accurate and timely records. 

S3: Recognise and report any factors that may adversely impact safe and effective care provision.

S25: Meet people’s needs for safety, dignity, privacy, comfort and sleep. 

S26: Meet people’s needs related to nutrition, hydration and bladder and bowel health. 

S27: Meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity. 

S28: Support people with commonly encountered symptoms including anxiety, confusion, discomfort and pain. 

S30: Recognise when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings and escalating as needed.

S38: Prioritise and manage own workload, and recognise where elements of care can safely be delegated to other colleagues, carers and family members.

 

                                                    BEHAVIOURS.

 

B1: Treat people with dignity, respecting an individual’s diversity, beliefs, culture, needs, values, privacy and preferences.

B2: Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice.

B3: Be adaptable, reliable and consistent, show discretion, resilience and self-awareness.