RESUMO
The outpatient dialysis setting presents unique challenges in the medication process. Dialysis staff conduct all steps in the medication process, including transcribing and verifying orders, preparing and administering medications, and monitoring for therapeutic and adverse effects. When addressing best medication practices, consideration should be given to education and resources provided to staff. This article explores the multiple strategies taken by a national dialysis network to support clinical staff and improve patient safety.
Assuntos
Erros de Medicação , Diálise Renal , Humanos , Erros de Medicação/prevenção & controle , Segurança do PacienteRESUMO
Chronic kidney disease-mineral and bone disorder (CKD-MBD) arises from a series of independent, yet interrelated, disturbances in bone and mineral metabolism. The consequences of failing to control CKD-MBD include increased mortality, cardiovascular and soft-tissue calcification, renal osteodystrophy, and endocrine and bone marrow disturbances. An understanding of the physiology and clinical consequences of the disease illustrates the necessity of simultaneously controlling parathyroid hormone (PTH), calcium, phosphorus, and calcium-phosphorus product (Ca x P), as recommended by the Kidney Disease Outcomes Quality Initiative (KDOQ).
Assuntos
Distúrbio Mineral e Ósseo na Doença Renal Crônica/etiologia , Hiperparatireoidismo Secundário/etiologia , Diálise Renal/efeitos adversos , Calcinose/etiologia , Calcinose/mortalidade , Cálcio/fisiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/mortalidade , Distúrbio Mineral e Ósseo na Doença Renal Crônica/diagnóstico , Distúrbio Mineral e Ósseo na Doença Renal Crônica/metabolismo , Distúrbio Mineral e Ósseo na Doença Renal Crônica/prevenção & controle , Homeostase , Humanos , Hiperparatireoidismo Secundário/diagnóstico , Hiperparatireoidismo Secundário/metabolismo , Hiperparatireoidismo Secundário/prevenção & controle , Falência Renal Crônica/complicações , Falência Renal Crônica/metabolismo , Falência Renal Crônica/terapia , Monitorização Fisiológica , Avaliação em Enfermagem , Hormônio Paratireóideo/fisiologia , Indicadores de Qualidade em Assistência à Saúde , Diálise Renal/métodos , Diálise Renal/enfermagem , Fatores de RiscoRESUMO
This is the third in a series of three articles examining cardiovascular disease (CVD) in the patient with chronic kidney disease (CKD). CVD is a leading cause of morbidity and mortality in patients with CKD, including those in the early stages. Early diagnosis of CKD and recognition of both traditional and nontraditional renal-related CVD risk factors are vital in improving outcomes for this population. Care of the patient with CKD should center on reduction of both types of risk factors for CVD. The ANNA Nephrology Nursing Standards of Practice and Guidelines for Care provide the basis for planning and providing care for patients with CKD and for reducing the risk of CVD in this patient population.
Assuntos
Doenças Cardiovasculares/complicações , Falência Renal Crônica/complicações , Anti-Hipertensivos/uso terapêutico , Proteína C-Reativa/análise , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Dislipidemias/complicações , Educação Continuada , Humanos , Hiperglicemia/complicações , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Prevalência , Proteinúria/complicações , Fatores de Risco , Abandono do Hábito de FumarRESUMO
Recent National Kidney Foundation Kidney Disease Outcome Quality Initiative Guidelines for cardiovascular disease recommend that patients with chronic kidney disease be considered at highest risk for development of cardiovascular disease and that cardiac risk factor reduction begin with diagnosis of chronic kidney disease. Risk factors for cardiovascular disease in patients with chronic kidney disease include both traditional and nontraditional renal-related cardiac risk factors. The ANNA Nephrology Nursing Standards of Practice and Guidelines for Care can provide the foundation for planning care to patients with CKD and not only slow the progression of CKD but reduce exposure to cardiac risk factors. This article, on the epidemiology of chronic kidney disease and the risk factors and complications that contribute to cardiovascular disease, is the first in a series of three articles on the risk factors and complications related to chronic kidney disease and its impact on cardiovascular disease.
