8: Coping with CKD Flashcards
What are the long term symptoms of chronic kidney disease?
Thirst
Anorexia
Osteoporosis
Malnutrition
Fatigue (due to anaemia)
People with CKD suffer a lot ___.
psychologically
anger, denial, depression, loss of self confidence
ICE
ask about impact of ckd on daily living e.g eating, relationships, occupation, hobbies
What aspects of diet are controlled in patients with CKD?
Fluid intake
Salt restriction
so big impact on diet
What problems do excess
a) potassium
b) salt (Na, Cl etc)
c) phosphorus
cause in CKD?
a) Arrythmia
b) Hypertension
c) Osteoporosis (causes hypocalcaemia)
How much fluid are people with CKD allowed each day?
1L - 1.5L minimum
The types of food that people with CKD can eat are ___.
limited
How do CKD patients adapt to strict fluid restrictions?
Use small cups or glasses
Sucking on ice cubes
How do CKD patients adapt to strict food restrictions?
Use smaller amounts of spicier foods
What do people with CKD tend to have as treats?
Chocolate
Crisps
Cheese
Fruit, veg and fish are high in which electrolyte?
Potassium
How should veg e.g broccoli be prepared to minimise its electrolyte content?
Boiled
which makes it mushy and tasteless
Red meat and dairy products are high in which electrolyte?
Phosphorus
What are the symptoms of fluid overload associated with drinking too much between dialysis sessions?
Peripheral oedema
Ascites
Pulmonary oedema +/- orthopnoea, PND
Apart from dialysis or palliative care, what is the other option for treatment of chronic kidney disease?
Kidney transplant
(Dialysis / Transplant) offers patients a much greater quality of life.
Transplant
don’t need to go in for dialysis or organise it yourself, freedom
What is a survey commonly used to assess a patient’s quality of life?
SF-36
36 questions
What drugs need to be given alongside transplants to prevent rejection?
Immunosuppression
Transplant patients on immunosuppression develop recurrent ___.
infection
What cancer is very common in transplant patients?
Skin cancer
long term immunosuppression
Which types of skin cancer are common in people on immunosuppression long-term?
BCC
SCC
Long term steroid immunosuppression suppresses what?
Adrenal axis
leading to addison’s, hirsutism
People on long term immunosuppression (gain/lose) weight.
gain weight
What are the two types of coping?
Avoidance coping (denial, anger, avoid confrontation)
Approach coping (confront, learn, take action)
separated by a transition phase
