Cervical myelopathy is a common neurologic condition among adults that is caused by deterioration of the cervical vertebrae leading to narrowing of the spinal canal and progressive spinal cord dysfunction. Symptoms develop insidiously, mimicking many common neurologic conditions and contributing to misdiagnosis and delay in treatment. Classic symptoms include gait instability, decreased dexterity of the hands, extremity pain, neck pain, and bladder dysfunction. The symptoms are variable based on level of the spine affected and severity of compression. Prompt recognition and early referral to neurosurgery for surgical evaluation can improve functional status and outcomes for symptomatic patients.
The COVID-19 pandemic disproportionately affected individuals with kidney disease causing significant morbidity and mortality worldwide. Sars-coV-2 infection has been linked to the development of acute kidney injury and worsening of underlying kidney function. Multiple challenges were encountered during the COVID-19 pandemic resulting in valuable lessons learned for future pandemics, public health emergencies, and disasters related to the care of individuals with kidney disease. The COVID-19 pandemic has further exposed the extensive need for more nurses to be knowledgeable about the care of kidney disease and able to provide specialized nephrology care.
Cirrhosis is a complex disease and has devastating effects on the liver. People living with the condition are at risk for many complications such as hepatorenal syndrome (HRS). If diagnosed with this condition, the prognosis is often poor. Therefore, it is imperative that treating providers are aware of the symptoms and methods to either prevent or adequately treat the syndrome. Timely referral, prevention, early recognition, and initiation of treatment are key components for prevention or improving the prognosis for HRS. Excluding potentially contributing factors and/or conditions is also vitally important for diagnostic purposes. Comorbid conditions may be present and further complicate diagnosis. Fluid volume replacement, administration of albumin, and vasoconstrictors as warranted are important for improving the hemodynamic status and potential reversal of HRS-acute kidney injury (HRS-AKI).
The COVID-19 pandemic disproportionately affected individuals with kidney disease causing significant morbidity and mortality worldwide. Sars-coV-2 infection has been linked to the development of acute kidney injury and worsening of underlying kidney function. Multiple challenges were encountered during the COVID-19 pandemic resulting in valuable lessons learned for future pandemics, public health emergencies, and disasters related to the care of individuals with kidney disease. The COVID-19 pandemic has further exposed the extensive need for more nurses to be knowledgeable about the care of kidney disease and able to provide specialized nephrology care.
The need for a workforce able to address the health care needs of older adults has been well established. Individuals with kidney disease experience an extensive number of transitions of care across health care settings related to the kidney disease process and the number of health care providers involved in their care. Kidney disease is multifactorial, and the prevention of progression of disease and poor outcomes are key to improving the health of individuals with kidney disease. Nurses and nurse practitioners can improve the outcomes for individuals with complex comorbid conditions and kidney disease especially during the transitions of care.
Medications are a common cause of injury to the kidney and can contribute to the increased progression of disease, poorer outcomes, and increased health care costs. Improved prescribing practices can decrease the risk for the development of acute kidney injury and the progression to end-stage kidney disease. KDIGO Clinical Practice Guidelines recommend the use of caution when prescribing potentially nephrotoxic medications for patients with kidney disease. More than 50-72% of individuals across all stages of kidney disease utilized potentially nephrotoxic medications contributing to poorer outcomes. Annually, 1.5 million adverse drug events causing medication-induced nephrotoxicity occur in the US. Medication-induced nephrotoxicity accounts for 14-26% of cases of AKI in adults and 16% of hospitalized children. It is imperative that nurses and all health care providers are practicing nephrotoxic stewardship to prevent medication-induced nephrotoxicity.
Cirrhosis is a complex disease and has devastating effects on the liver. People living with the condition are at risk for many complications such as hepatorenal syndrome (HRS). If diagnosed with this condition, the prognosis is often poor. Therefore, it is imperative that treating providers are aware of the symptoms and methods to either prevent or adequately treat the syndrome. Timely referral, prevention, early recognition, and initiation of treatment are key components for prevention or improving the prognosis for HRS. Excluding potentially contributing factors and/or conditions is also vitally important for diagnostic purposes. Comorbid conditions may be present and further complicate diagnosis. Fluid volume replacement, administration of albumin, and vasoconstrictors as warranted are important for improving the hemodynamic status and potential reversal of HRS-acute kidney injury (HRS-AKI).
Hypertension is the most common primary diagnosis in the United States. Multiple sequelae of disease states are attributable to hypertension. Minimal to modest improvements in blood pressure can result in improved cardiovascular-related health outcomes. Despite the wealth of information available regarding the management and treatment of hypertension, the widespread control of hypertension continues to be an elusive challenge. A collaborative effort between patient and clinician using a balance of pharmacologic and nonpharmacologic interventions is essential to effectively manage and treat hypertension to avoid target organ damage. Prevention of acute organ damage related to hypertensive emergencies demands immediate intervention.
Hypertension is the most common primary diagnosis in the United States. Multiple sequelae of disease states are attributable to hypertension. Minimal to modest improvements in blood pressure can result in improved cardiovascular-related health outcomes. Despite the wealth of information available regarding the management and treatment of hypertension, the widespread control of hypertension continues to be an elusive challenge. A collaborative effort between patient and clinician using a balance of pharmacologic and nonpharmacologic interventions is essential to effectively manage and treat hypertension to avoid target organ damage. Prevention of acute organ damage related to hypertensive emergencies demands immediate intervention.
