NRSG534 - Renal: Complexities in Renal Nursing

Year

Credit points

Campus offering

Prerequisites

NRSG524 Advanced Pathophysiology for Specialty Nursing Practice AND NRSG525 Evidence-based, Person-centred Family Care in Specialty Nursing Practice

Unit rationale, description and aim

This unit builds on students’ existing nursing knowledge and skills and will equip students with theoretical knowledge and critical thinking skills to safely care for individuals with renal disease. This unit will focus on developing advanced skills on renal disease by critically examining the pathophysiology, risk factors, epidemiology and classification of acute kidney injury and chronic kidney disease. Students will examine potential treatment options of individuals with renal disease and assess the impact of renal disease on health and wellbeing. Additionally, students will examine different renal replacement therapy such as hemodialysis and peritoneal dialysis for patients with end stage kidney disease and discuss different venous access devices used in renal replacement therapy. With diabetes mellitus being one of the common cause of chronic kidney disease. This unit will also explore the impact of diabetes nephropathy among individuals in a primary health and acute health setting. The aim of this unit is to provide nurses with advanced theoretical knowledge and critical thinking skills on the complexities of renal disease and prepare them for practice in the management of individuals with renal disease. 

Learning outcomes

To successfully complete this unit you will be able to demonstrate you have achieved the learning outcomes (LO) detailed in the below table.

Each outcome is informed by a number of graduate capabilities (GC) to ensure your work in this, and every unit, is part of a larger goal of graduating from ACU with the attributes of insight, empathy, imagination and impact.

Explore the graduate capabilities.

On successful completion of this unit, students should be able to:

LO1 - Analyse anatomical, physiological, developmental and pathophysiological concepts related to complex health problems in renal nursing (GA4)

LO2 - Assess the impact of renal disease, whilst critically reflecting upon the key pathophysiological concepts that contribute to comorbidity and complex care required for renal patients (GA3, GA4, GA5, GA8, GA9)

LO3 - Examine the risk factors for renal disease and appraise and implement a range of assessment techniques and strategies for early identification to prevent deterioration and increase well-being (GA3, GA4, GA5, GA8, GA9)

LO4 - Evaluate the treatment options available for patients with renal disease and how they influence an individual’s health and wellbeing (GA1, GA2, GA3, GA6, GA8)

LO5 - Critically evaluate the implications of pharmacological interventions when managing individuals with renal disease (GA1, GA2, GA3, GA6, GA8)

Graduate attributes

GA1 - demonstrate respect for the dignity of each individual and for human diversity

GA2 - recognise their responsibility to the common good, the environment and society 

GA3 - apply ethical perspectives in informed decision making

GA4 - think critically and reflectively 

GA5 - demonstrate values, knowledge, skills and attitudes appropriate to the discipline and/or profession 

GA6 - solve problems in a variety of settings taking local and international perspectives into account

GA8 - locate, organise, analyse, synthesise and evaluate information 

GA9 - demonstrate effective communication in oral and written English language and visual media 

Content

Topics will include:

Renal diseases and disorders

• Glomerular disorders including nephrotic and nephritic syndrome
• Hypertension
• Cystic/polycystic nephritis
• Reflux Nephropathy

Diabetic nephropathy

• Aboriginal and Torres Strait Island Australians and diabetic nephropathy
• Diabetic nephropathy and primary health

Acute Kidney Injury

• Epidemiology
• Risk factors
• Diagnosis & classification
• AKI subgroups
• Pre-renal intrinsic injury
• Post-renal AKI
• Rhabdomyolysis
• Management and complications of AKI

Chronic Kidney Disease

• Epidemiology
• Classification of Chronic Kidney Disease
• Stages of Chronic Kidney Disease
• Risk factors
• Chronic Kidney Disease pathophysiology
• End Stage Kidney Disease
• Hypertension and resistant hypertension
• Management of Chronic Kidney Disease
• Management of cardiac morbidity

Renal replacement therapy

• Haemodialysis
• General principles of dialysis
• Haemodialysis and components of system
• Types of vascular access devices
• Peritoneal dialysis
• Peritoneal Dialysis/Peritonitis
• Management of fluid and electrolytes
• Transplantation
• Supportive (non-dialytic) care
• Advance care planning
• Symptom control
• Palliative care
• Ethical, social and family issues of palliative care and withdrawing treatment

Drugs commonly used in Nephrology

• Drugs to manage electrolytes and bone effects of renal disease
• Drug considerations affecting blood cells in renal disease
• Drugs to manage the immune system following renal transplant

Learning and teaching strategy and rationale

This unit is offered in online mode and uses an active and collaborative learning approach to support students to analyse and critically evaluate approaches to providing evidence-based, ethical nursing care within a renal nursing setting. Students will engage in readings and reflections, e-Learning activities and opportunities to collaborate with peers in an online environment. This can involve, but is not limited to, online discussion forums, chat rooms, guided reading and webinar sessions. In addition, e-Learning and links to electronic readings will be provided to guide students’ reading and extend other aspects of online learning.

Through an online learning platform, students will have the opportunity to reflect on the complexity of delivering person-centred care to patients in renal settings. Online learning in this unit will be supported by the provision of opportunities for students to attend online webinar sessions that allow synchronous exchange of information and facilitate responses to queries generated by students in relation to unit content. For those unable to participate in synchronous webinar sessions, recordings will be available.

Students are required to complete online activities and assessments to demonstrate the application of knowledge. The learning and teaching strategy used in this unit allows flexibility for students while ensuring they have expert support. These modes of delivery assists students to link knowledge and skills to the renal nursing context, and to develop shared meanings through online reflections and discussions.

Assessment strategy and rationale

In order to successfully complete this unit, a minimum combined total grade of all assessment tasks of 50% is required to pass this unit.

The assessment strategy used in this unit encourages depth of learning and provides the students the opportunity to develop their capacity to interpret, translate, apply and evaluate evidence-based care provision in renal settings. In order to develop renal nursing knowledge and skills required to achieve the learning outcomes and graduate attributes, students first demonstrate the ability to undertake a case study on a patient with diabetic nephropathy, a significant and potentially life-limiting complication. Knowledge and skills gained in this assessment task are then further developed in the final assessment where students will then apply learned knowledge to critically analyse and evaluate strategies used to promote health and wellbeing in individuals with renal disease.

Overview of assessments

Representative texts and references

Bryant, B., & Knights, K. (2019). Pharmacology for health professionals (5th ed.). Elsevier. Pharmacology for Health Professionals - ClinicalKey for Nursing 

Bullock, S., & Hales, M. (2019). Principles of pathophysiology (2nd ed.). Pearson. https://ebookcentral.proquest.com/lib/acu/detail.action?docID=5495513

Danovitch, G. M. (2017). Handbook of kidney transplantation (6th ed.). Wolters Kluwer. https://acu.primo.exlibrisgroup.com/discovery/fulldisplay?vid=61ACU_INST%3A61ACU&tab=Everything&isFrbr=true&docid=alma991012722489402352&searchScope=61ACU_All&context=L&lang=en

Daugirdas, J. T. (2019). Handbook of chronic kidney disease management (2nd ed). Wolters Kluwer. https://ezproxy-acu-edu-au.ezproxy2.acu.edu.au/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=2356855&site=ehost-live&scope=site

Daugirdas, J. T., & Blake, P. G., & Ing, T. S. (2015). Handbook of dialysis (5th ed). Wolters Kluwer.

https://acu.primo.exlibrisgroup.com/permalink/61ACU_INST/f9cqvr/alma991012684849002352

Gois, Healy, H. G., Ranganathan, D., Mallett, A. J., Webster, A. C., Kanellis, J., Barraclough, K., Wainstein, M., Johnson, D. W., & Kerr, P. G. (2021). Nephrology in Australia. In J. Moura-Neto, Divino-Filho. & C. Ronco (Eds.)., Nephrology Worldwide (pp. 701–721). Springer International Publishing. https://doi.org/10.1007/978-3-030-56890-0_52. https://link-springer-com.ezproxy2.acu.edu.au/chapter/10.1007/978-3-030-56890-0_52

Patton, K., & Thibodeau, G. (2019). Anatomy & physiology (10th ed.). Elsevier/Mosby. Anatomy and Physiology, Adapted International Edition - ClinicalKey for Nursing (acu.edu.au)

Roelofs, & Vogt, L. (2019). Diabetic Nephropathy Pathophysiology and Clinical Aspects (1st ed.). Springer International Publishing. https://doi.org/10.1007/978-3-319-93521-8. https://link-springer-com.ezproxy2.acu.edu.au/book/10.1007/978-3-319-93521-8

Schrier, R.W. (2015). Manual of nephrology (8th ed.). Wolters Kluwer. https://ebookcentral.proquest.com/lib/acu/detail.action?docID=2035707

Thomas. (2019). Renal nursing: care and management of people with kidney disease (5th. ed.). Wiley Blackwell.

https://ebookcentral.proquest.com/lib/acu/detail.action?docID=5797267&pq-origsite=primo

Urban, A.K., Foote, C., Brennan, F.P., Brown, M. & Lee, B.W.H. (2019). Retrospective chart review to assess domains of quality of death (recognition of dying, appropriate limitations, symptom monitoring, anticipatory prescribing) of patients dying in the acute hospital under the care of a nephrology service with renal supportive care support over time. Nephrology, 24(5), 511-517.