CRITICAL THINKING CARE STUDY

Jamie is a 16-year-old teenager with chronic kidney disease. He lives with his mother
and a younger sister, 10 years old. He’s homeschooled because he has to miss 3 days
of school each week for hemodialysis.

1. You notice that although Jamie is supposed to limit the amount of potassium he
ingests, when offered a choice between popcorn with orange juice or raisins and
milk for an afternoon snack he chose the raisins and milk. Was that his best
choice?

2. Jamie appears obese because of the long-term use of immunosuppressants. You

hear him brag to his girlfriend that he has lost more weight than her as part of a
New Year’s resolution pact. You also notice, according to Jamie’s medicine
reminder sheet, that he has missed taking two doses of prednisone. Would
omitting taking prednisone cause him to lose weight? What could be the effect of
omitting his prescribed prednisone?

3. Jamie’s mother wants him to learn to drive so he can travel to the dialysis center
by himself. Jamie says he can’t do that because dialysis makes him feel dizzy and
nauseated. Are those common symptoms of dialysis? As his dialysis nurse, what
could you do to reduce his symptoms?