성인간호학(3) 케이스

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1. Acute kidney injury (AKI)

대상자는 1년 전 레이노증후군 진단을 받고 약물 복용 중이었으나, 내원 10일 전부터 오심이 있어 문경제일병원에 입원하였고 AKI 소견으로 경과 관찰 중 고인산혈증 악화, 오심 및 호흡곤란이 동반되어 투석 및 관리를 위해 ER을 통해 본원에 입원하였습니다. 현재 HD 카테터 삽입 중이며 주기적으로 혈액 투석을 받고 있습니다.
2. Raynaud's phenomenon

대상자는 1년 전 레이노증후군 진단을 받고 약물 복용 중이었으나, 다리 궤양 및 홍반이 발생하여 본원 피부과, 류마티스 내과 진료를 받았습니다.
3. Systemic sclerosis (Scleroderma)

대상자는 1년 전 레이노증후군 진단을 받고 약물 복용 중이었으나, 다리 궤양 및 홍반이 발생하여 본원 피부과, 류마티스 내과 진료를 받았고, 전신경피증(Systemic sclerosis) 의심 소견이 있습니다.
4. Skin infection

대상자는 다리 피부 병변이 있어 감염 위험성이 있으며, 이에 대한 감염 징후 및 피부 관리 방법에 대해 교육을 받았습니다.
5. Sleep disturbance

대상자는 낯선 병원 환경으로 인해 수면장애를 겪고 있습니다.
6. Anxiety

대상자는 치료 과정과 질병 예후에 대한 불안감을 가지고 있습니다.

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1. Acute kidney injury (AKI)

Acute kidney injury (AKI) is a serious medical condition that requires prompt diagnosis and treatment. AKI is characterized by a sudden decline in kidney function, leading to the accumulation of waste products in the body. This can be caused by a variety of factors, including dehydration, infections, medications, and underlying medical conditions. Early recognition and management of AKI are crucial to prevent further kidney damage and potentially life-threatening complications. Treatment typically involves addressing the underlying cause, supporting kidney function, and managing fluid and electrolyte balance. Patients with AKI require close monitoring and may need dialysis or other interventions depending on the severity of their condition. Preventing AKI through proper hydration, medication management, and prompt treatment of underlying conditions is an important aspect of patient care.
2. Raynaud's phenomenon

Raynaud's phenomenon is a condition characterized by the constriction of blood vessels, typically in the fingers and toes, in response to cold temperatures or emotional stress. This can lead to a characteristic color change in the affected areas, often starting with whiteness, followed by blueness, and then redness as the blood flow is restored. Raynaud's can be primary (idiopathic) or secondary to an underlying condition, such as autoimmune disorders, connective tissue diseases, or vascular diseases. Proper management of Raynaud's involves identifying and addressing any underlying causes, as well as strategies to minimize exposure to cold and manage stress. Pharmacological treatments, such as vasodilators, may be used in more severe cases. Educating patients on the condition and providing them with strategies to manage their symptoms can significantly improve their quality of life.
3. Systemic sclerosis (Scleroderma)

Systemic sclerosis, also known as scleroderma, is a complex and often debilitating autoimmune disorder that affects the skin, blood vessels, and internal organs. The hallmark of the disease is the excessive production and deposition of collagen, leading to the thickening and hardening of affected tissues. This can have a significant impact on the function of various organ systems, including the skin, lungs, heart, and gastrointestinal tract. Effective management of scleroderma requires a multidisciplinary approach, involving rheumatologists, dermatologists, and other specialists, to address the diverse manifestations of the disease. Treatment may include immunosuppressive medications, vasodilators, and supportive therapies to manage specific organ involvement. Early diagnosis and comprehensive care are crucial to improve patient outcomes and quality of life. Ongoing research into the pathogenesis and novel therapies for scleroderma is essential to better understand and manage this challenging condition.
4. Skin infection

Skin infections can range from mild, localized conditions to severe, life-threatening systemic infections. They can be caused by a variety of pathogens, including bacteria, viruses, fungi, and parasites. Prompt recognition and appropriate treatment of skin infections are essential to prevent complications and the spread of infection. Factors that can increase the risk of skin infections include poor hygiene, compromised immune function, underlying skin conditions, and exposure to contaminated environments. Treatment typically involves antimicrobial therapy, topical or systemic, depending on the severity and type of infection. In some cases, surgical intervention may be necessary. Educating patients on proper skin care, hygiene, and early recognition of signs of infection can help to prevent and manage skin infections effectively. Ongoing research into new antimicrobial agents and strategies to combat the growing threat of antibiotic resistance is crucial in the management of skin infections.
5. Sleep disturbance

Sleep disturbances can have a significant impact on an individual's physical and mental well-being. Factors such as stress, anxiety, medical conditions, and lifestyle habits can contribute to the development of sleep disorders, including insomnia, sleep apnea, and circadian rhythm disruptions. Addressing the underlying causes of sleep disturbances is essential for effective management. This may involve cognitive-behavioral therapy, sleep hygiene education, and, in some cases, the use of pharmacological interventions. Promoting healthy sleep habits, such as maintaining a consistent sleep schedule, creating a relaxing sleep environment, and limiting exposure to blue light before bedtime, can also be beneficial. Healthcare providers should take a comprehensive approach to evaluating and treating sleep disturbances, as they can have far-reaching consequences on an individual's overall health and quality of life. Continued research into the mechanisms and management of sleep disorders is crucial to improve patient outcomes.
6. Anxiety

Anxiety is a common and often debilitating mental health condition that can significantly impact an individual's daily life. It is characterized by persistent feelings of worry, fear, and apprehension, which can lead to physical symptoms such as muscle tension, rapid heartbeat, and difficulty concentrating. Anxiety can be triggered by a variety of factors, including stressful life events, underlying medical conditions, and genetic predisposition. Effective management of anxiety often involves a combination of psychotherapy, such as cognitive-behavioral therapy, and pharmacological interventions, when appropriate. Lifestyle modifications, such as regular exercise, stress management techniques, and mindfulness practices, can also be beneficial in managing anxiety symptoms. Healthcare providers should take a holistic approach to addressing anxiety, considering the individual's unique circumstances and providing personalized treatment plans. Ongoing research into the neurobiology of anxiety and the development of novel therapeutic interventions is crucial to improve the quality of life for individuals struggling with this condition.

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