Discuss the care and treatment provided in hospital during his admission and how Ron responded to the treatment
My speciality of work focuses on end stage renal disease (ESRD) patients and their management. My selected patient for this case is 37years old indigenous gentleman called Ron (pseudonym) from remote community performing self-care haemodialysis 3 times a week in his community dialysis facility. Ron diagnosed with chronic kidney disease (CKD) in 2010 January due to his untreated long term hypertension. Ron become an ESRD patient in 2011 March and commenced haemodialysis through left radiocephalic arteriovenous fistula created in June 2010. Systolic hypertension is one of the major factor to develop ESRD (Allison, 2012).
Ron got air lifted to emergency department from his community for breathlessness due to fluid overload and chest infection after missing 2 dialysis sessions. Ron missed 2 dialysis to attend his nephews funeral in his out station where no facility for dialysis. Attending funeral is culturally very important among indigenous Australians. Fluid overload is one of the major complications in ESRF patients (Lin, Yu, & Chen, 2005). Ron got further the medical history of coronary artery disease, raised cholesterol, arterial fibrillation, heart failure, chronic gout and elevated parathyroid hormone. Ron got admitted to ICU for emergency dialysis and transferred to renal ward for further medical management. Ron got treated with intra venous (IV) piperacillin with tazobactam (Tazocin) 4.5g BD for 5days followed by oral antibiotics for his chest infection and other oral medications for his various other comorbidities. Ron got discharged from the hospital in a stable condition and his medication list on discharge is followed:
Augmentin duo 625mg BD
Amlodipine 10mg OD
Allopurinol 100mg BD
Aspirin 100mg OD
Atorvastatin 20mg OD
Calcitriol 0.5mcg OD
Digoxin 62.5mcg OD
Paracetamol 1gm QID
Sevelamer 800mg TDS with food
Oxycodone 10mg PRN maximum 4th hourly.
In the final essay I would be discussing the past and present medical history of the case including social issues. I would also discuss the care and treatment provided in hospital during his admission and how Ron responded to the treatment. This would also cover the medications used in the hospital, on discharge, its pharmacokinetics, pharmacodynamics and potential drug drug interactions and recommended actions