Acute Renal Failure: Gordons Functional Health Patterns - Report Example

Acute Renal Failure Lakiasha Branch Dr. T. Murray Coppin College of Health Professions Helene Fuld School of Nursing Nursing 311 Medical Surgical Nursing November 29, 2012 Acute Renal Failure Acute renal failure is a disorder that mainly occurs in the event that the blood being supplied to the kidney is interrupted abruptly or in some cases when toxins overload the kidney. This condition results in acute failure like injuries, accidents, or in some situations surgeries complications causing the kidney to be deprived of its normal blood flow. In addition to these internal effects of the acute renal failure to the patients, there are external effects of the disease which have proved to be even more difficult to deal with. This paper is going to examine the Gordon’s Functional health patterns as well as Myra Levine’s Model is relation to how acute renal failure affects the patient. Gordon’s Functional Health Patterns Marjorie Gordon developed functional health patterns to form a guideline when it comes to the establishment of a nursing data base that is comprehensive. She placed the patterns into different categories making it possible for a data collection process that is standardized and systematic (Dunn and Hood, 2009). These patterns have assisted nurses over the years in determining different human and health function aspects; a) Health Perception and Health Management. This category focuses on an individual’s perceived health level as well as well-being. This includes the individual’s activities in trying to keep healthy (Dunn and Zambraski, 2009). The habits that may be regarded as detrimental to a given health condition are evaluated. b) Nutrition and Metabolism. The assessment in this case is focused on food pattern and fluid consumption in relation to metabolic needs. Here, the evaluation of local supplies adequacy takes place. c) Elimination. This area mainly concerns itself with excretory patterns experienced on the skin, bladder and bowel. Excretory issues like constipation, diarrhea, incontinence and urinary retention can be easily identified d) Activity and Exercise. Focused is directed to the daily living activities that need energy expenditure, and they include leisure activities and exercise. e) Sleep and Rest. The individual’s rest, sleep and relaxation practices are assessed. Sleep patterns that are dysfunctional, sleep deprivation responses and fatigue can be identified. f) Self-Perception and Self-Concept. The individual’s attitude towards themselves is the issue of concern and this includes body image, identity, and self-worth. The identification process in this case concerns itself with the self-esteem level and threats response to the individual self concept (Dunn, 2009). g) Roles and Relationships. The role played by an individual is the one being assessed as well as how the individual relates with others. h) Sexuality and Reproduction. Person satisfaction or in some cases dissatisfaction in relation to reproductive functions and sexuality patterns are to be assessed under this category. i) Coping and Stress Tolerance. The individual’s stress perception and the way he or she copes with stress are examined. j) Values and Belief. The belief and values of an individual are assessed and this includes the individual’s spiritual beliefs. Myra Levine’s Model In her model, Myra came up with four principles that were meant to serve nurses as a guide to promoting wholeness: 1. Conservation energy. The interventions by nurses have to be gauged on the individual capacity so as to give room for additional demands. 2. Conservation of Structural Integrity. Nurses should be in a position to limit the extent of a given disease through recognizing the disease early enough and applying prompt intervention (Hershman, 2009). 3. Conservation of Personal Integrity. The patients are the most vulnerable in the event of any disease, and it results in privacy loss as well as mounting anxiety. Nurses are thus charged with the responsibility of maintaining the patient’s integrity through maintaining privacy and respecting the patient wishes. 4. Conservation of Social Integrity. Nurses meet this principle through meeting their professional roles and appreciating the interpersonal relationships of patients (Hebert, 2009). The two models mentioned above will help us understand the effects of acute renal failure and how patients and nurses react to such effects. Personal Integrity When patients learn of the acute renal failure news, they are likely to be shocked; thus, they need help from both nurses and the family for them to accept this threatening condition. Support groups also come in handy as they offer support to both the family and patient in coping with the tragedy. The nurses, family and support groups should serve as safe outlets for the patients to discuss their emotions and fears (Coresh, 2009). Considering the Health Perception and Health Management strategy as per Gordon’s health patterns, nurses are expected to offer information on treatment, management and new research options to the patient. Acute renal failure patients are normally affected by the feeling of anxiety as well as depression. The best way to deal with this situation is to talk to the patient about such feelings. By refereeing to the Coping and Stress Tolerance pattern strategy, it will be harder for the patient to adapt to renal failure if he or she keeps the anxiety and sadness inside. Stress is most experienced during the transplantation time as it is a delicate decision to make in life. To cope with the anxious situation, the patient can open up to the nurses, doctors and family regarding his or her concerns and fears and take time to read more about the process and ways of managing it before and after the transplant (Hebert, 2009). Structural Integrity Patients suffering from renal failure tend to change in their appearance. Some patients have been observed to have pale or yellow skin. Some patients may also have flaky and dry skin making it darker. This may lead the patients to seek other means of dealing with the change in appearance such as using cosmetics. Other structural changes may include changes in body weight following retention, fluid loss or the medicines used during transplantation. In some cases, the smell of the mouth may change following the buildup of waste material in the body (Mucsi, 2009). Nurses handling renal failure cases are mostly involved in monitoring, technical and evaluative RRT aspects especially at the final stages of renal failure. The nurses are also involved in preparing patients for RRT and also apply their specialist’s skills in the prevention and handling of renal failure (Mucsi, 2009). The nurses are also expected to be involved in guiding the patients with regards to their medication, diet, exercise and rehabilitation programmes. Social Integrity The sexuality of patients has been observed to change with the onset of renal failure. The interest of the patients in social activities also changes. One of the most disturbing effects is witnessed in men where the patient can become impotent. Emotional reason like depression, fear of death or disability or marital issues may greatly impact sexual functioning. The Sexuality and Reproduction pattern as per Gordon can be used to asses the sexual dissatisfaction and go ahead to apply the Conservation of Social Integrity to make the patient aware and appreciate their condition and go ahead to advice the patients on the treatment as well as the way to deal with their sexuality and relationships (Valderrabano, 2009). Evidence Based Practices (EBP) is the delivery of care that is of high quality basing on the client wishes, available evidence and clinical judgments so as to come with the best outcomes for the patients with renal failure. EBP improves the decision making process of the nurses as well as identifies systematic appraises, knowledge gap and puts together evidence to assist in the implementation of clinical expertise (Valderrabano, 2009). Energy Integrity After transplantation, it is important for the patient to follow the recommended medication and diet. Failure to do so may result in serious complications like heart attack, bone disease, death and stoke. Rejection of the new kidney is also one of the major effects. These above effects call for the need for proper diet, exercise and sleep/rest patterns (Fructuso, 2011) The Nutrition and Metabolism and Activity and Exercise patterns as well as the Conservation Energy principle offer guidelines on how the nurses should step in and gauge the patient capacity with regards to additional demands such as metabolism and nutrition and activity and exercise (De Sousa, 2008). By the patients sticking to the recommended fluid and diet restrictions, they will successfully respond to transplant and dialysis. Medication reminders as well as pill boxes can serve as reminders to patients so that they do not forget to take their medicine. Exercise programs are important and should be first approved by the doctor so as to increase the patient’s endurance and strength so as to prevent fatigue, reduce depression, and increase the general quality of life (Leung, 2009). Transplantation and dialysis on renal failure patients have raised many legal questions in relation to the ethics of the patients. The main concern is always on the criteria used to access such treatment considering the available financial resources and as well as patient’s characteristics. The use of medical judgment as well as the social worthiness criteria normally applied to renal failure patients has been observed as being unethical in some cases calling for the intervention of state and federal officials to intervene (Leung, 2009). References Coresh, J. et al. (2009). Prevalence of chronic kidney disease in the United States. JAMA; 298:2038-47. De Sousa, A. (2008). Psychiatric issues in renal failure and dialysis. Indian J Nephrol. 18:47-50. 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