Dialysis Experience Essay Example for Free

Dialysis Experience Essay Hemodialysis (HD) is one of several renal replacement therapies used for the treatment of end stage kidney disease (ESKD) and kidney failure. Dialysis removes excess fluids and waste products and restores chemical and electrolyte balance. HD involves passing the patient’s blood through an artificial semipermeable membrane to perform the filtering and excretion functions of the kidney. One important step before starting regular hemodialysis sessions is preparing the vascular access; ideally, a vascular access should be placed weeks or months before you start dialysis. The early placement of the vascular access will allow sufficient time for the access to heal and mature. The three basic kinds of vascular access for hemodialysis are an arteriovenous (AV) fistula, an arteriovenous (AV) graft, and a venous catheter. Peritoneal dialysis (PD) occurs though diffusion and osmosis across the semipermeable peritoneal membrane and capillaries. The peritoneal membrane is large and porous. It allows solutes and water to move from an area of higher concentration in the blood to an area of lower concentration in the dialyzing fluid (diffusion). The fluid and waste products dialyzed from the patient move through the blood vessel walls, the interstitial tissues, and the peritoneal membrane and are removed when the dialyzing fluid is drained from the body through a siliconized rubber (Silastic) catheter that is surgically placed into the abdominal cavity. PD is slower than hemodialysis (HD), however, and more time is needed to achieve the same effect. As far as treatment options, both have complications. Hemodialysis includes Disequilibrium syndrome, muscle cramps, hemorrhage, air embolus, cardiac dysrhythmia, and Hemodynamic changes such as hypotension and anemia. Peritoneal dialysis complications include protein loss, peritonitis, hyperglycemia, respiratory distress, and bowel perforation. Hemodialysis Nursing care and roles are to monitor the patient immediately and for several hours after dialysis for any side effects from the treatment. Common problems include hypotension, headache, nausea, malaise, and vomiting, dizziness, and muscle cramps. The nurse must obtain vital signs and weight for comparison with pre-dialysis measurements. Blood pressure and weight are expected to be reduced as a result of fluid removal. Hypotension may require rehydration with IV fluids, such as normal saline. The patient’s temperature may also be elevated because the dialysis machine warms the blood slightly. If a fever results, sepsis may be present and a blood sample is needed for culture and sensitivity. The heparin required during hemodialysis increases the clotting time and thus the risk for excessive bleeding. All invasive procedures must be avoided for 4 to 6 hours after dialysis. Continually monitor the patient for hemorrhage during dialysis and for one hour after. Peritoneal dialysis nursing care and roles are to start and monitor during PD. Before treatment, assess baseline vital signs including blood pressure, apical and radial pulse rates, temperature, quality of respirations, and breath sounds. Weigh the patient, always on the same scale, before the procedure and at least 24 hours while receiving treatment. Weight should be checked after a drain and before the next fill to monitor the patient’s dry weight. Baseline laboratory tests, such as electrolyte and glucose levels, are obtained before starting PD and are repeated at least daily during the treatment. Vital signs need to be recorded every 15-30 minutes. Assess for signs of respiratory distress, pain, discomfort. Dressing around the catheter site must be checked every 30 minutes for wetness during procedure. Maintain accurate inflow and outflow records. The nurse monitors the treatment to make sure the client is getting the right amount of hemodialysis to remove enough wastes from the blood. About once a month, the client’s blood will be tested by using one of two formulas; urea reduction ratio (URR) or total urea clearance (Kt/V). The physician may adjust the hemodialysis intensity and frequency based on the test results. These labs are crucial and must be checked monthly while being on dialysis. Mr. L was the gentleman I chose to assess, he was very friendly and talkative; has been a dialysis client for the past three years. He has dialysis treatments three times a week, and treatments are approximately 3 to 4 hours long depending on his level that day. I asked Mr. L how he felt about being on dialysis and his response was â€Å"In the early days of dialysis, I would not even drive myself home. I would just collapse on the couch in he living room and be there until morning. But all that has changed. I now drive myself to and from dialysis, and I feel just fine after. I even have a part time job now. I tend to be very hungry after dialysis so I try eating something as soon as I get home. Just one evening recently it was like old times. It was because the nurse took off more than I wanted and my body really reacted to it. I just went home and collapsed. I was not even able to work the next day. But that is very rare for me. † I enjoyed our conversation and my experience at the dialysis center.

McCarthyism: The Modern American Witchhunt :: Essays Papers

McCarthyism: The Modern American Witchhunt "Have you no sense of decency sir, at long last? Have you left no sense of decency?" -Joseph Welch, lawyer for the Secretary of the Army Introduction By the time Republican Senator Joseph R. McCarthy gave his first speech in which he accused 205 members of President Harry Truman's democratic government of being communist on Feb. 9, 1950 there was already a lingering anti-Communist attitude in the United States. Which is why his speech, given in West Virginia, far from Washington DC, and from his home state of Wisconsin, made such an impact. Most of what he said has been forgotten, the speech was never recorded, but what he started with that speech would win him and his actions a place in American history. McCarthyism: a word synonymous with lying, government cover-ups and abuse, and the private war of one man against what he saw as a threat to the American way of life. Countless lives would be ruined by his crusade. , those of government officials and private citizens alike. When it was all over McCarthy's vehemence would bring his own downfall. MaCarthy and his followers caused panic and fear of communism in those who were ordinary citizens. For those who were targeted and accused, however, McCarthy and his followers did much more. How it was done Governmental structures, local and federal, set up various un- American activites committees. These committees were set up solely to find and prosecute communists, or suspected communists. They drew the attention of the American public in every city that they were, furthering the panic of the "red scare." They set up inquisitions to take care of their targets. Loyalty review boards were set up by President Truman in 1947, and were used quite frequently in the 1950's. Nearly all public employees were forced through these boards, although most went through swiftly without trouble. These boards were not able to imprison people, but they were able to take their jobs from them. Private industries were often more harsh on their employees suspected of being communist. To avoid public embarrassment that could be detrimental in the ultra- patriotic 1950's they would often hire people who were ultra-patriotic to weed out the communist, or suspected communists in their corporations.

Vacant Chapter 7 Tradition

For the second time since she came into my life, Emily and I walk away from the Gale Street Shelter. After making the trip with her last year, which was her first Christmas without her mom, I know how important â€Å"giving back† really is especially where Emily is concerned. I can't help but glance over at her as we make the journey home. This girl – woman – has been part of my life for 487 days, give or take a few hours. As I look back now, I realize I'm keeping track because the day I met Emily was the day I began to live, a rebirth in the form of a brunette angel who's never asked for anything, yet I can't help giving her everything I can. The past year has been filled with much patience and restraint on my part. As I realize Emily is still a child in the eyes of the law, I struggle to keep my mind on a virtuous path. Sometimes I swear she's torturing me. This morning she decided to get a drink of orange juice after taking a shower but before getting dressed. She says she likes the taste of orange juice while the mint of the toothpaste lingers. I walked out of the bedroom, and there's Emily†¦ bending over†¦ reaching for juice†¦in a towel. And because I'm frugal, our towels are cheap and on the small side. I think she knows she's torturing me when she stands there, flexing her leg. I leave the house without my lunch or coat in haste to escape. I don't want to continue down this path with my thoughts. I've made a vow to myself that my relationship with Emily will remain chaste, but it doesn't mean I don't have to redirect my thoughts on a consistent basis. I'm only human. On my way to work I make a mental note to save some money so I can buy her a robe†¦ with full coverage. The temperature has dropped since our arrival at the shelter this morning, so we walk quickly. This is our Christmas tradition now. Emily asked that we visit last year as a way to remember her mother. Now, I see how lucky we truly are with what we have. There are so many who have nothing. Our home may lack many of the modern conveniences and technological advances of most, but we are healthy, bellies full, and we have a roof over our heads. Helping to serve dinner and visit with the shelter patrons is a way for Emily and me to pay it forward. We don't exchange expensive gifts. Instead, I always get her a new kitchen gadget from the Dollar Store, and she always bakes me butterscotch cookies. It's not much, but it's meaningful and the only thing that counts to us. As my arm swings with the rhythm of my feet, I brush Emily's fingers with my own. It's an innocent accident, though the sudden warmth in my chest is anything but. I'm not sure how much longer I'll be able to keep up this ruse, playing her brotherly protector. While Emily has never spoken about boys in her class or voiced interests of the romantic sort, I know it's inevitable. She has blossomed into a beautiful creature who has no idea of the devastation her beauty wreaks upon me and, surely, the boys around her. Her smile is infectious, and it's only a matter of time before a suitor comes knocking at our door. I kind of feel sorry for the poor boy, as my first time meeting him will most likely be ugly. I'm a fierce guardian where Emily is concerned, not just because it's my duty to protect her but because seeing Emily with another guy will end me. I want to reach out and take her hand in mine as we walk, but I don't. I have calculated the difference in our ages. Five years doesn't seem all that much when she is twenty and I'm twenty-five. However, she is seventeen and still a minor, which is the only important difference, no matter how hard my libido begs to differ. I have to prepare for her to have romantic feelings for someone her own age, not a twenty-two year-old guy who has to act like her older brother. Sisters rarely hold hands with their brothers. â€Å"Why don't you go out on dates?† Emily suddenly asks in the middle of New Year's Day dinner. She insists on serving black-eyed peas because they are lucky if you eat them on the first day of the year. They taste like shit, but as usual, I humor her by eating them. â€Å"Huh?† I stall. She's familiar with my deliberate stall tactic and narrows her eyes at me. â€Å"I've never seen you with a woman.† She pauses, like she's unsure how to broach the next part. â€Å"I mean, you're a good looking guy. There have to be opportunities for you to go out†¦Ã¢â‚¬  She stops and takes a deep breath as if preparing herself for my answer. â€Å"Uhhh†¦Ã¢â‚¬  Yep. â€Å"Never mind, Ethan. I can tell it's not a topic you want to talk about.† With that, she leaves the table and her half-eaten plate and heads for the bedroom, one of her only options for privacy . The door closes and I'm left feeling more confused than ever. I'm learning that girls are confusing, especially where Emily is concerned.

Voices From The Street Exploring The Realities Of Family...

Gultekin, L., Brush, B. L., Baiardi, J. M., Kirk, K., Vanmaldeghem, K. (2014). Voices From the Street: Exploring the Realities of Family Homelessness. Journal of Family Nursing, 20(4), 390-414. doi:10.1177/1074840714548943 The purpose of this study were to conduct focus groups with homeless mothers and their case workers in Detroit, Michigan, to explore the pathways into homelessness, to understand the day to day experiences of living in shelters, the process of rehousing, identify real and perceived barriers of homeless families attempting to reestablish stable housing, and to understand the impact of the homeless families’ complete health and welfare. The design and sample of the study were a simple qualitative and descriptive design and consist of seven caseworkers and twenty-one homeless mothers and broken into four focus groups. 90 minutes semi-structured interviews were used during the focus groups for data collection. The analysis of the data collected from the focus groups of homeless mothers identified four predominant themes that illuminate these women experiences with homelessness: Pathways to and the meaning of homelessness, daily shelter life and the rehousing process, impact on health and well-being, and personal needs and wants. Then the analyses of the data collected from the caseworkers were evaluated to find similarities and differences of perceptions, which lead to several significant findings that included the following; reports of family historiesShow MoreRelatedStreet Children17655 Words   |  71 Pages_______________________ ___________________ Name Examiner Signature _______________________ ___________________ ACKNOWLEDGMENTS Well, I have enjoyed various supports from different people and organizations through out my work on this senior essay; and I am grateful to each one of them. Assefa Melka, my advisor, I am thankful to your friendly advise on my work and free offerings that you provided me with. I wish youRead MoreAn Employers Guide Inclusive Workplace16409 Words   |  66 Pagessolutions to business problems. Inclusive workplaces that openly communicate their values and strategies on equality, human rights and inclusion are capitalising on this as they are able to attract a wider pool of applicants and talent. Candidates from minority groups may be put off applying for positions in organisations that do not make their commitment to inclusion known. Retain productive and committed staff Inclusive workplaces that understand the needs of their employees and make staffRead MoreAbstract: Strategic Contingency Planning23625 Words   |  95 PagesContingency planning should be part of an organization’s quality cycle as well. â€Å"Business continuity and disaster recovery have gained somewhat in the eyes of top corporate management since the start of the 1990s. As the industry has slowly evolved from what could almost have been called a ‘black art’ to something starting to resemble a disciplined science, basic business principles have begun to become increasingly relevant† (Rothstein, 2003, p. 1). Purpose of this Study In this study, theRead MoreDeveloping Management Skills404131 Words   |  1617 PagesWeidemann-Book Credits and acknowledgments borrowed from other sources and reproduced, with permission, in this textbook appear on appropriate page within text. Copyright  © 2011, 2007, 2005, 2002, 1998 Pearson Education, Inc., publishing as Prentice Hall, One Lake Street, Upper Saddle River, New Jersey 07458. All rights reserved. Manufactured in the United States of America. This publication is protected by Copyright, and permission should be obtained from the publisher prior to any prohibited reproductionRead MoreInnovators Dna84615 Words   |  339 Pages(Continued from front flap) is the Horace Beesley Professor of Strategy at the Marriott School, Brigham Young University. He is widely published in strategy and business journals and was the fourth most cited management scholar from 1996–2006. is a professor of leadership at INSEAD. He consults to organizations around the world on innovation, globalization, and transformation and has published extensively in leading academic and business journals. is the Robert and Jane Cizik