Explanation:
One hemodialysis patient may cope well with a complication, whereas another response to the same issue with significant stress and worry and manages poorly. This may be due to the individuals' varying levels of resilience. The capacity for stability is the capacity to react to demanding circumstances positively and healthily—a patient who is resilient enough to handle things properly. Strength is frequently linked to an optimistic mindset, supportive families, and spirituality.
Explanation:
The patient should be informed that four to six weeks are required to assess response if an SSRI (fluoxetine 20 mg daily) prescribed for depression in a patient with ESKD and hemodialysis does not improve after two weeks. Tricyclic antidepressants are generally avoided due to their higher risk of side effects. Depression harms the quality of life and raises the dangers of morbidity and immorality. Patients with chronic renal disease frequently experience depression, and hemodialysis often worsens.
Explanation:
The nurse should take suicidal ideation into account if a patient on hemodialysis with a history of ongoing depression has recently started skipping treatments and failing to take prescribed medications, despite adverse physical reactions, and the patient appears cheerful and insists he is fine but "busy" and "forgot" about the treatments. Hemodialysis patients risk their lives by skipping appointments and prescriptions, and doing so offers a quick way to commit suicide. Patients occasionally act happier or even upbeat once they have decided to kill themselves.
Explanation:
The non-pharmaceutical therapy that may be most effective in assisting the patient in coping if a patient on hemodialysis experiences regular periods of depression despite taking an SSRI is cognitive-behavioural therapy. CBT teaches patients techniques to replace negative thoughts with positive ones to improve how they think about things. The ability to identify automatic thoughts (cognitive distortions) such as all-or-nothing thinking, catastrophizing, "mind reading," and personalization is taught to patients. Treatment is typically only temporary (5 to 20 sessions).
Explanation:
Two litres of dialysate containing the contrast material (often Omnipaque 300) are injected into the peritoneal cavity if a patient has to have a contrast-associated CT to help show the extent of the hernia. The patient should be instructed to walk around or be active for two hours after installation. This encourages the dye to travel freely inside the peritoneal cavity and into the hernia. The hernia's location will determine if a CT scan is always required. For instance, an examination may reveal the full extent of an umbilical hernia.
Explanation:
The American Kidney Fund helps dialysis patients with financial needs through several programs.
-Grants Management System (GMS): Patients can apply directly for grants.
-Health Insurance Premium Program (HIPP): Assists with Medicare Part B, Medigap, COBRA, and other insurance premiums.
-Safety Net Grants: Assists with treatment-related expenses not covered by insurance.
-Sanofi Renal/Genzyme Patient Assistance Programs: Provides Renvela® and IV formulations of Hectorol® for those without prescription drug coverage.
-Prescription Drug Resources: Provides lists of drug companies with special programs and resources for those without prescription drug coverage.
Explanation:
Ultrasonography, which can reveal if a catheterized mass is fluid-filled, is the most common way to tell a hernia apart from a hematoma or seroma in patients who have developed such a mass. The ultrasound is non-invasive and reasonably priced. Up to 20% of individuals using peritoneal dialysis develop one or more hernias, including ventral, perineal, umbilical, inguinal, and femoral hernias. High-volume dialysate use, sitting, performing the Valsalva maneuver, obesity, and multiparity are risk factors.
