As Betty 's Chronic Kidney Disease (CKD) has progressed to stage 5, she is mainly concerned about the progressive symptoms she has been experiencing and the emotional wellbeing of Alan and her family not being able to cope when she passes away. Betty was described as "not clinically depressed" and is completely aware of her diagnosis. At this advanced stage of kidney disease, the kidneys have lost their function to remove waste and fluids from the body, toxin build up and regulating blood pressure (stage 5 of chronic kidney disease, 2016). In addition, Betty has been concerned about her hypertension, odeomeous legs, dyspnoea (shortness of breath), pruritus (itching), nausea and lethargy. Medication tablets have also raised concerns to Betty as she has difficulty swallowing them and states she might "choke". This may be due to the lack of salivation or fluid restrictions (Pinto, Silva, & Pinato, 2016). …show more content…
It was important for Betty to be around her loved ones including her daughter Cheryl and her grandchildren during her end of life. Q2- "Patients with end-stage kidney disease have significantly increased morbidity and mortality" (FASSETT et al., 2010).
Because Betty has withdrawn from dialysis, Advanced care planning and end-of-life decisions still need be sustained by palliative care. From the perspective of the nursing discipline, the nurses role should incorporate symptom management, emotional support for both the patient and grieving family and acknowledge any cultural beliefs/decisions (FASSETT et al., 2010).
Symptom management and treatment interventions in the ESKD for Betty include- starting a syringe driver for pain management/relief
Collaborative medication management
Review care plan with general