UNIVERSITY OF GUYANA

DSW 2201- SOCIAL WORK THEORY AND PRACTICE II (PRACTICUM)

MEDICAL SOCIAL WORK DEPARTMENT

NEPHROLOGY SOCIAL WORKER

NAME: TIFFANI ST. MARTHE

LECTURE: WENDY COLLINS

DEPT SUPERVISIOR: MR. C. NEWMAN

DATE: 03 RD MAY, 2024

INTRODUCTION TO DIALYSIS DEPT.

There are 5 stages of kidney failure stages 1, 2, and 3 (which show no

specific symptoms, but the kidney is slowly declining), stage 4 (where
the function is low and treatment should be considered), and lastly stage
5 (this is the crucial stage where the kidney is no longer removing waste
and not able to function).
For those suffering from kidney failure, dialysis is an essential medical
therapy that helps them control their disease and stay healthy. It is vital
to offer patients on the ward who have been advised to undergo dialysis
thorough education and preparation for the procedure.
 EXPLANATION OF KIDNEY
FUNCTION
. Removing wastes and extra fluid from the body

. Regulating acid levels

. Balancing water, salts, and minerals in the blood

. Producing hormones that control blood pressure, stimulate red blood

cell production, and promote bone health
 CAUSES OF KIDNEY FAILURE
Renal failure, another name for kidney failure, can result from many
conditions that impair the kidneys' ability to operate normally. Two
primary categories can be used to classify the causes of kidney failure:
. Acute renal failure (TYPE 1 & 2 DIABETES)
. chronic kidney failure ( HIGH BLOOD PRESSURE)
OVERVIEW OF CAUSES of KIDNEY
DISEASE
TYPE 1 & 2 Diabetes: Uncontrolled diabetes over time can damage the
small blood vessels in the kidneys and impair their ability to filter waste
from the blood effectively.

High Blood Pressure (Hypertension): Prolonged high blood pressure

can cause strain on the blood vessels in the kidneys, leading to
progressive damage and eventual kidney failure.
TREATMENT FOR KIDNEY DISEASE
Although there is no known cure for chronic kidney disease (CKD),
there are therapy options that can aid in the proper management of the
condition.
. Pharmaceuticals: managing related issues such as diabetes, elevated
cholesterol levels, and high blood pressure (Vit. E, Erythropoietin, iron,
active vit. D)

. Lifestyle Improvements: Adopting healthier practices including giving

up smoking, eating a balanced diet, and exercising frequently.
TREATMENT FOR KIDNEY DISEASE
• . Dialysis: To help remove waste from the blood and reproduce some
of the kidney's functions.

• Kidney Transplant : can substitute a healthy donor kidney for damaged

kidneys in those with advanced chronic kidney disease (CKD, stage 5)
or renal failure.
TYPES OF DIALYSIS OFFERED BY
GPHC
There are two main types of dialysis commonly used for patients with
kidney failure:

1. HEMODIALYSIS- a process where blood is filtered through a

dialyzer, an artificial kidney, outside the body. Two needles are
placed in the arm to connect the patient to the dialysis machine,
which pumps the blood through the filter, removes waste products,
and returns the filtered blood to the body.
NOTE: Government subsidies can be provided for such therapy
Con’t.
2. PERITONEAL DIALYSIS-A catheter is placed in the belly through a
surgical procedure and dialysis solution, a mixture of water and salt,
flows into the belly to absorb waste and extra fluid. The used solution is
drained, and the fresh solution is added for further filtration. This
process needs to be repeated daily to effectively cleanse the blood.
NOTE: this dialysis allows you to be in the comfort of your home.
CASE STUDY
• Client’s Name (Masked): Mr. Smith
• Client’s Background Information: Mr. Smith, age 44 was admitted to
the Male Surge Ward 2, for a history of elevated hypertension. Causing
him to feel exhausted, shortness of breath, and swelling in his lower
limbs.
• Recommendations by Doctor: The evaluation conducted by the doctor
assigned to his case indicated that dialysis treatment is necessary to
manage his medical condition, especially that is kidney function blood
test results was decreasing. The doctor would have requested the patient
for Dialysis Treatment and counseling sessions with Dialysis Social
Worker, Ms. Cane.
COLLABORATION WITH MEDICAL
SOCIAL WORKER
In determining the patient's psychological requirements, financial
standing, need for emotional support, and general ability to adjust to the
advised dialysis treatment. The Nephrology social worker was
vital. Working along with her allowed me to have hands-on knowledge
and experience as a future Medical Social Worker
TYPES AND METHODS OF DATA
COLLECTION FOR THE CASE
QUALITATIVE DATA
1. INTERVIEWS
2. OBSERVATION
3. PATIENT’S CHART REVIEWS

QUANTITATIVE DATA
. Laboratory Test Reports/Results
 INTERVENTION STRATEGIES USED
FOR CASE
. PSCHYOSOCIAL ASSESSMENT- Understanding the patient's emotional
state (fear, anxiety), support system (Siblings, children), financial coping
mechanisms (life savings), and any possible obstacles when
providing medical treatment.
. EDUCATION- sharing knowledge with patients about their condition,
treatments, lifestyle changes, self-management techniques, treatment plans,
and empowering them to make informed decisions about their care .
.CARE CO ORDINATION- financial support accessibility.
. EMOTIONAL SUPPORT- observing signs of fear and anxiety, pt. was
counseled.
FOLLOW UP AND MONITORING
• During our follow-up visit to the ward, we discussed starting dialysis treatment.
• Mr. Smith has considered it carefully but decided not to pursue dialysis at this
time due to a family member persuading him that artificial products can be used
to treat his conditions.
• The COGNITIVE BEHAVIOUR THERAPY treatment approach was used as
an intervention.
• Relatives were contacted and scheduled for a council session, but they refused
and ended the call.
• Patient insists on taking self-discharge and refused further counseling
• The doctor was informed and information was documented in chart and
progress notes.
Follow up
• Patient was contacted after immediate self-discharge
• Patient refused to answer calls for follow
• Patient relatives were contacted and they also refused counseling
• Relatives indicated that Mr. Smith’s decision remains the same and
also asked for follow-up calls to be stopped