NRS 410 Discuss how elimination complexities can affect the lives of patients and their families
NRS 410 Discuss how elimination complexities can affect the lives of patients and their families
Positive and negative psychological attitudes affect the waste elimination processes. Stress, embarrassment, isolation, anxiety, and body image issues, hasten gastrointestinal problems. For example, studies indicate that stress increases constipation and abdominal pain syndrome (Lopresti, 2020). This restricts bowel movement, limiting waste elimination processes. However, communication, education, and support from family and nurses ease bowel movements, increasing the waste elimination process. A positive attitude towards gastrointestinal issues can improve the waste elimination procedures such as bladder and bowel movements. Empathy towards the patients can decrease any irregularities in the waste elimination lifecycles.
Lopresti, A. L. (2020). The effects of psychological and environmental stress on micronutrient concentrations in the body: a review of the evidence. Advances in Nutrition, 11(1), 103-112. https://doi.org/10.1093/advances/nmz082
Elimination complexities are conditions that interfere with the normal excretion process of the body. There are several elimination structures in the human body including the pancreas, gastrointestinal systems renal and biliary structures. When these structures fail to function effectively they result to problems in the excretion system thereby resulting to elimination complexities. Uremia is an example of elimination disorder which occurs when kidney fails to filter toxins in urine. Elimination complexities affect the lives of the patient and their families greatly. Apart from the physical health impacts the condition has on patients, elimination complexities also lead to psychological and emotional stress (Castellan et al., 2016). Studies show that families and patients with end-stage renal disease experience psychological financial and emotional stress.
The severity and extent of the complexity differs from person to person depending also on the structure being affected. Some complexities are associated with symptoms that may limit patients’ interaction in social place due to fear of stigma. Families are faced with psychological stress seeing their loved ones in the condition. All these lead to anxiety and depression (Sharma &Bhutta, 2022). In addition to that, families may stress out due to high financial costs needed for treatment and symptoms management. Nurses play a great role in supporting patients with elimination problem. Emotionally, nurses can hold conversations with the patients allowing the patient to express how they feel about their condition. In the conversations, nurses can instill hope by educating the patient on their condition and providing them with relevant information and data.
Castellan, C., Sluga, S., Spina, E., & Sanson, G. (2016). Nursing diagnoses, outcomes and interventions as measures of patient complexity and nursing care requirement in Intensive Care Unit. Journal of Advanced Nursing, 72(6), 1273-1286. https://doi.org/10.1111/jan.12913
Sharma, P., & Bhutta, B. S. (2022). Assisting Patients With Elimination. In StatPearls [Internet]. StatPearls Publishing.
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Elimination complexity is the medical term that defines this health condition which can be disastrous if not addressed on time (Cohen, 2018). First, this condition is financially costly for patients, which implies that they will get affected economically. Treatment of some of the elimination complexities, such as urine elimination concerns, is costly (Schonberger, 2018). Some have financial assistance from family members, which also affects them financially. Also, the condition affects work attendance among working patients, thus making them suffer more economically. Besides, psychological problems such as stress, anxiety, and fear are prevalent among sick persons and their families (Schonberger, 2018).
Elimination complexes can have a variety of effects on patients and their families. Patients, for example, may feel embarrassed or ashamed of their condition, as well as isolated and alone. Families may struggle to cope with the day-to-day care of a loved one with an elimination complex. The nurse’s role in addressing the patient’s psychological and emotional needs is to offer encouragement, support, and understanding.
The daily care of a loved one with an elimination complex can be daunting and challenging for families. The nurse can help provide information about resources available to help the patient and family cope with the condition.
The challenges associated with an elimination complex can lead to feelings of isolation for families too. The nurse can also provide encouragement by sharing stories of other patients who have successfully managed their condition.
Allshouse, C., Comeau, M., Rodgers, R., & Wells, N. (2018). Families of children with medical complexity: a view from the front lines. Pediatrics, 141(Supplement_3), S195-S201.
Cohen, R. I. (2018). Lean methodology in health care. Chest, 154(6), 1448-1454.
Schonberger, R. J. (2018). Reconstituting lean in healthcare: From waste elimination toward ‘queue-less’ patient-focused care. Business Horizons, 61(1), 13-22.
One example of elimination complexity is chronic kidney disease. Chronic kidney disease is a progressive irreversible disease that affects the kidneys (Whitney, 2018). It has stages from 1 to 5 and progressives slowly in the beginning. Some common causes of kidney disease are hypertension, diabetes, nephrosclerosis, renal calculi, and nephrotoxins (Whitney, 2018). Kidney failure is based on glomerular filtration rate.
Nursing management and teaching for chronic kidney disease start at first treatment, during, and at discharge (Whitney, 2018). At first, the nurse needs to identify the potential toxins, nephrotoxic agents that pose a threat to patients’ renal function, and risk factors (Whitney, 2018). Some procedures that can cause the toxins due to the contrast are computed tomography, cardiac catheterization, and pacemaker implantations (Whitney, 2018). A nurse needs to get lab work to get a patient’s baseline for serum creatinine level and BUN prior to administering contrast dye (Whitney, 2018). A nurse should monitor these levels after the procedure and also to educate the patient to monitor urine output and report decrease urine output immediately.
Patients and family’s needs support with a patient with renal disease. These patients and families need emotional, psychological support to help them thru the disease process. These patients’ life will revolve around dialysis treatments, transplants, and eventually death (Whitney, 2018). These patients need encouragement and support and assistance to maintain quality of life. They need coping skills, spiritual care, education to maintain treatment plans, self-care, and physical activity (Whitney, 2018). Nurses need to help set goals for recovery and independence, support groups, and education of the disease process. These will help eliminate stress and anxiety. Nurses need to educate the patient throughout the process and promote independence.
Whitney, Stacey (2018). Pathophysiology: Clinical applications for client health. Grand Canyon University (Ed). https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/Chapter/3
Elimination complexities such as kidney disease can result from treating other conditions. Chemotherapy treatments for cancer, for example, pose a risk for complications such as nephrotoxicity. Chemotherapy drugs can cause various renal and electrolyte disorders (Małyszko et al., 2017). Chemotherapy can affect the glomerulus, tubules, interstitium, or renal microvasculature—clinical manifestations range from an elevation of serum creatinine to acute renal failure requiring dialysis (Małyszko et al., 2017). Other factors can potentiate renal dysfunction contributing to nephrotoxicity of antineoplastic drugs, including the use of other nephrotoxic drugs (e.g., antibiotics, NSAIDs, radiographic contrast), urinary tract obstruction due to tumor, and other comorbidities such as diabetes, HTN, CHF, or the malignancy itself (Małyszko et al., 2017). Tumor lysis syndrome is another complication that can affect the kidneys, as the massive tumor cell lysis causes a high level of potassium, phosphate, and uric acids in the circulatory system (Małyszko et al., 2017). The early diagnosis and prompt treatment of kidney and electrolyte disorders are essential; monitoring kidney function before and during treatment is vital to identifying nephrotoxicity.
Imagine being a patient already stressed and devastated with a cancer diagnosis, then adding complications such as ARF requiring dialysis. Patients and their families will need education and emotional and spiritual support. Offering outpatient support counseling or support groups, as well as online resources for additional education, can help.
Małyszko, J., Kozłowska, K., Kozłowski, L., & Małyszko, J. (2017). Nephrotoxicity of anticancer treatment. Nephrology Dialysis Transplantation, 32(6), 924–936. https://doi.org/10.1093/ndt/gfw338
The body’s elimination structures are many and compound, including the renal, pancreatic, hepatic, biliary, and gastrointestinal systems (Whitney, 2018). These structures are necessary for good health. As a result, when these structures fail, the physical and emotional impact on both patients and their family can be momentous. The extent of the impact is determined by the brutality of the dysfunction as well as the structure affected. Families of children with end-stage renal disease and chronic kidney disease, for example, face significant psychosocial, emotional, and financial stress. Caregivers are affected in nearly every aspect of their lives by this condition, which “results in emotional, marital, social, and financial dysfunction, leaving families feeling disempowered to deliver the complex care…required” (Bignoll & Goldstein, 2018). Having a child with a chronic condition like this increases a parent’s chances of depression, unemployment, and marital dysfunction.
Whiney, S. (2018). Elimination Complexities. Pathophysiology Clinical Applications for Client Health. Retrieved from https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/3
Bignoll, R. & Goldstein, S. (2018). Childhood CKD Affects the Entire Family. American Journal of Kidney Disease. Retrieved from https://www.ajkd.org/article/S0272-6386(14)01468-1/fulltext
The human body is comprised of several elimination systems, and they are all interconnected; these systems include the liver, pancreas, kidneys, bladder, biliary, and the GI system. With the many structures that are involved, elimination issues may occur due to a variety of different medical conditions; for instance, post-surgical patients are at risk for ileus, congenital malformations in infants can cause bowel and bladder disruption, and cancer patients and the elderly can have altered elimination secondary to drugs and therapy, according to Sharma & Butta (2022). Urinary and bowel incontinence or constipation and impaction are problems that also occur often in disabled patients.
The nurse’s role in supporting them psychologically and emotionally is paramount to the management of these disorders. As Whitney (2018) discusses, nurses need to be sensitive to their plight, as they are already greatly affected by their illness, and even find it demoralizing. Anxiety and depression often accompany many of these diagnoses, and family members may be under a great deal of stress because their loved one is greatly distressed. Knowledge is power and arming the patients and loved ones with information that will help them understand the disease can help relieve a great deal of the stress that accompanies it. Information that can be shared with them is prescription info; info on support groups; and information about the management of their disease, to name a few.
Sharma, P. & Bhutta, B.S. (2022). Assisting patients with elimination. In: StatPearls Publishers. https://www.ncbi.nlm.nih.gov/books/NBK559258/
Whitney, S. (2018). Elimination complexities. In Grand Canyon University (Ed), Pathophysiology: Clinical applications for client health. https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/#/chapter/3