** This session earns RN and CCM Ethics **
Chronic kidney disease is one of the most difficult diseases to case manage. This is due to the absence of signs and symptoms, until the disease has progressed to the point where a patient is faced with the reality of starting dialysis. Understanding how the disease progresses, risk factors, and possible contributors to worsening the disease, can help case managers to educate, support, and prepare the patient for life changing health decisions.
The Kidney patient is like a multi-faceted jewel. The different sides of the stone are unique factors that can affect the patient and the progression of their disease. The understanding of each one of these facets can assist the nurse case manager in identifying barriers and health related concerns that can result in an emergency room visit or hospital admission. Barrier and concerns can be both physical and emotional/mental. They can range from chronic conditions related to kidney disease, over-the-counter and prescribed medications, diet choices, imaging testing with contrast, to the home dynamics and emotional state of mind.
The world of chronic kidney disease can be overwhelming to patients and caregivers. Case managers who possess knowledge of the disease, laboratory testing, diet restrictions and medications prescribed for management, and who are able to present the information in a way that is non-threating and understandable, is the cornerstone to successful case management of chronic kidney disease.