PKD: How Can Nurses Help?
The treatment of Polycystic Kidney Disease is mostly about managing the symptoms. Nurses can do a lot to help with this! For PKD patients we want to monitor fluids, manage pain, and keep the kidneys as healthy as possible for as long as possible. We also want to treat related conditions, such as kidney or urinary tract conditions as soon as possible to prevent further damaging the kidneys.
There are many common symptoms of PKD including pain, high blood pressure and fluid retention. Nurses can work in tandem with patients to manage these symptoms.
Symptom or Concern
|
Nursing Interventions
|
Infection (UTI, kidney cyst infection, etc)
|
Administer antibiotics as prescribed, manage associated pain, monitor
vitals for signs of infection, monitor lab values
|
Pain
|
Pain management with non-NSAID medications as ordered, heating pads, comfort measures such as visiting with the patient, listening to music
|
Kidney Stones
|
Encourage fluid intake, manage pain, monitor urine for the passage of
the stone and blood in the urine
|
High Blood Pressure
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Provide patient education on exercise, encourage a low sodium diet,
administer anti-hypertensives as ordered
|
Fluid Retention
|
Administer diuretics as ordered, encourage a low salt diet
|
In an outpatient setting, it's important for the nurse to let the patient know when they should contact their doctor. The following signs warrant a call to the doctor:
-Blood in the urine
-Increasing or unusual flank pain
-Swelling of the extremities
-Decreased urine output
-Fever, lethargy, malaise, generally feeling of being unwell which could indicate infection
If the patient has a severe headache they should call 911 immediately as PKD is associated with an increased risk of aneurysms.
Patient education is also important when talking about the treatment options as the disease progresses. For example, most patients will undergo hemodialysis instead of peritoneal dialysis. Nurses should be familiar with both and be able to explain the procedure to patients and families. Many people with PKD also will undergo a kidney transplant, understanding the procedure and the outcomes, including the need for lifelong immunosuppresant medications.
The Dialysis Nurse
Many patients with PKD progress to End Stage Renal Disease and rely on dialysis to take the place of their failing kidneys. The dialysis nurse accesses the dialysis catheter under sterile conditions and hooks the patient up to the dialysis machine. The nurse is also responsible for monitoring the patient during dialysis, as well as weighing the patient before and after.
Image of nurse & patient: http://blog.soliant.com/wp-content/uploads/Nurse1.jpg
Info from: Polycystic kidney disease. (n.d.). Retrieved February 19, 2015, from
http://www.mayoclinic.org/diseases-conditions/polycystic-kidney-disease/basics/definition/con-20028831
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