NURBN2016, 2019
Assignment – 2
Page 1 of 2
NURBN 2016 ASSESSMENT TASK 2: Case Scenario
Melanie Johnson is a 55-year-old, mother of 5 kids and lives in a rural Victorian town. She
married Frank who is an electrician, for 18 years. They live on a farm, tending to be selfsufficient
growing their veggies, some fruit and have chicken and cows. Their five kids are
aged between 10 and 15 years. Melanie does home-schooling for all her kids. She got
concerned with her feeling of increasing tiredness, nausea and general pruritus. She told
Frank that it was not just related to her menopause but she suspects it to be something
more serious.
She visited her GP, who found her BP to be 190/110mm Hg. Although she is not diagnosed
with hypertension, she admitted getting severe headaches and sometimes palpitations for
over 5 years, when she was worried about the drought. She has been taking Ibuprofen and
naproxen for the headaches over nearly 12 years but did not seek medical help as they
would settle. Further, she was referred to a nephrologist and was diagnosed with chronic
renal failure. After reviewing her blood results below, Melanie has been advised to undergo
renal replacement therapy (Haemodialysis) after creating an arteriovenous fistula (AV
fistula)
Her blood results were:
GFR (glomerular filtration rate) was found to be 10ml/min/1.73m2
Hb (Haemoglobin) was 95g/L
Serum Potassium was 5.7 mmol/L
Serum Urea 17 mmol/L
Serum Creatinine 90 umol/L
Part 1. (1000 words)
1.1 Briefly describe the renal anatomy and physiology (200 words)
1.2 Discuss the pathophysiology of chronic renal failure in Melanie, including her risk
factor(s), possible complications and treatment options (500 words)
1.3. Identify at least 6 differences between Acute and Chronic renal failure. (100 words)
1.4. Discuss renal replacement therapy (haemodialysis) with clear links to Melanie’s case.
(200 words)
Part 2. (650 words)
Melanie has been commenced on tablet valsartan 80 mg OD and injection Eprex 50 IU/kg iv
three times/week, apart from other drugs.
2.1 Discuss the two medications used for Melanie, with rationale and clear links to her case.
Include 4 major side effects and 4 nursing considerations relevant to Melanie for each drug.
NURBN2016, 2019
Assignment – 2
Page 2 of 2
(500 words)
2.2 Discuss the GFR and Hb blood test performed for Melanie. What do her results indicate
(GFR and Hb only)? (150 words)
Part 3. (350 words)
3. Melanie asks how she can manage her chronic renal failure.
– Discuss what the teach-back method is? (100 words).
– Using the teach-back method, discuss how you would educate Melanie to manage her fluid
intake in relation to her diet. (250 words).
