Patient Education Strategy Client, Sarah Collins, has chronic kidney disease. She receives dialysis twice a week. Today when Mrs. Collins arrives at the dialysis clinic, the nurse assesses Mrs. Collins and notes her blood pressure is 145/90 mm Hg and she has gained three pounds since her last visit. Mrs. Collins tells the nurse she was trying earlier to walk to her mailbox at the end of the driveway and couldn’t because she was out of breath. Mrs. Collins’ husband and 16-year-old grandson are at the clinic with her. Identify 3-5 appropriate nursing interventions and teaching points for your client based on the pathophysiology and assessment findings. Describe the educational strategies that should be incorporated when building a plan of care for your client. Support with rationale.
SOLUTION – Patient Education Strategy Client: Sarah Collins chronic kidney disease
Based on the assessment findings and the pathophysiology of chronic kidney disease (CKD), as well as the patient’s symptoms and situation, here are 3-5 appropriate nursing interventions and teaching points for Sarah Collins:
- Blood Pressure Management:
- Nursing Intervention: Assess Mrs. Collins’ current medication regimen for hypertension and ensure compliance with prescribed antihypertensive medications.
- Teaching Point: Educate Mrs. Collins and her family on the importance of strict adherence to her prescribed antihypertensive medications to control her blood pressure within the target range (<130/80 mm Hg for CKD patients) and prevent further kidney damage and cardiovascular complications.
- Rationale: Uncontrolled hypertension is a significant risk factor for the progression of CKD and cardiovascular events. By optimizing blood pressure control, the risk of further kidney damage and associated complications can be minimized.
- Fluid Management:
- Nursing Intervention: Assess Mrs. Collins’ fluid intake and output, including monitoring her weight gain between dialysis sessions.
- Teaching Point: Educate Mrs. Collins and her family on the importance of strict fluid restriction between dialysis sessions to prevent volume overload, exacerbation of heart failure symptoms, and pulmonary edema.
- Rationale: Excessive fluid intake can lead to fluid overload and exacerbate symptoms of heart failure in patients with CKD. Strict fluid restriction is crucial to maintaining fluid balance and preventing complications associated with volume overload.
- Activity and Exercise Guidelines:
- Nursing Intervention: Assess Mrs. Collins’ current activity level and functional status, including her ability to perform activities of daily living and engage in physical activity.
- Teaching Point: Educate Mrs. Collins and her family on the importance of incorporating regular physical activity into her daily routine, such as walking or light exercise, to improve cardiovascular health, maintain muscle strength, and enhance overall well-being.
- Rationale: Regular physical activity has been shown to improve cardiovascular fitness, reduce blood pressure, and improve overall health outcomes in patients with CKD. Encouraging Mrs. Collins to engage in appropriate exercise can help manage her symptoms and improve her quality of life.
- Nutritional Counseling:
- Nursing Intervention: Assess Mrs. Collins’ dietary habits and nutritional status, including her adherence to a renal-friendly diet prescribed for CKD.
- Teaching Point: Provide Mrs. Collins and her family with dietary education and counseling on following a renal-friendly diet low in sodium, potassium, and phosphorus to help manage her CKD and prevent further kidney damage.
- Rationale: Nutrition plays a critical role in managing CKD and preventing complications. Following a renal-friendly diet can help control blood pressure, reduce the risk of electrolyte imbalances, and slow the progression of kidney disease.
Educational Strategies:
- Individualized Teaching:
- Tailor education and counseling sessions to Mrs. Collins’ learning needs, preferences, and cultural beliefs to enhance understanding and retention of information.
- Demonstration and Reinforcement:
- Use visual aids, demonstrations, and hands-on activities to reinforce key teaching points and enhance learning comprehension.
- Family Involvement:
- Involve Mrs. Collins’ husband and grandson in the educational process to ensure they understand their roles in supporting her care and adherence to treatment recommendations.
- Written Materials:
- Provide written materials, such as pamphlets, brochures, or educational handouts, for Mrs. Collins and her family to review at home and reference as needed.
- Follow-Up and Monitoring:
- Schedule regular follow-up appointments and monitoring sessions to assess Mrs. Collins’ progress, address any concerns or questions, and reinforce education as needed.
By implementing these nursing interventions and educational strategies, Mrs. Collins can better manage her CKD, reduce the risk of complications, and improve her overall quality of life.