Question

Elavorate a teaching plan for a patient with CHF and CKD referent hydratation and fluid intake.

Answer 1

Educating patient is a major role of a registered nurse in the healthcare setting. The health of the patient after reaching home also important for nurses. So, it is our responsibility to give adequate information based on patient needs when they get home.

CHRONIC KIDNEY FAILURE (CKF) AND CONGESTIVE HEART FAILURE (CHF):

Heart failure is a chronic progressive medical condition that affects the proper functioning of the heart pump. Lack of functioning of this pump is due to weakend heart muscle or due to the inability of the heart muscle to handle excess fluid. The symptoms of heart failure are: a) fatigue b) shortness of breath and c) edema.

The main function of the kidney is filtering of waste products from the blood and eliminating them in the urine. This organ is also responsible for removing excess fluid in the body. In renal failure patients, there is a sudden loss of kidney function, leading to muscle weakness, seizures and also accumulates nitrogenous wastes in the body.Teaching patients about renal failure about fluid intake help them to aware of their conditions and also helps to achieve an optimal level of health.

The sudden changes in these organs results in fluid retention which further leads to fatigue, shortness of breath and edema. Fluid restriction should be maintained in both these cases to avoid overload on fluid intake. So, it is the duty of a nurse to give education on fluid intake in both the cases.

If you eat more sodium diet or drink too much fluid, the body's water content level raises and make heart and kidney to work harder. The education for a CHF and CKD patient includes

a) The patient should be made aware of the restriction of fluid intake. Normal intake may lead to edema and shortness of breath due to less kidney function. So, the usual recommendation for a daily intake in patients with CKD is urinary output in a day plus 500ml (1.5 Litres/day in case of moderate to severe Kidney failure).

b) Educate the patient to avoid binge drinking and be vigilant in replacing extra fluids during hot climates and during episodes of diarrhoea and vomiting.

c) Dietary restriction on sodium and potassium is mandatory.

d) Advice them to have more fruits and vegetables as it contains less amount of salts.

f) Daily Weight monitoring.

g) Alcohol and tobacco consumption should be reduced.