Poststreptococcal Infections: Patient Safety and Education (Nursing)

00:01 Now we're ready for what I call Professor Lawes' big three.

00:05 I know that's all interesting information and you love to learn that's cool.

00:08 I love it that were hanging out.

00:10 But what really matters is you're wanting me to know how does this make a difference on my test scores? That's what I'm here to help you do.

00:17 So the big three questions I have is why does a nurse need to know this? How does it keep a patient safe? And how do I apply this information to an exam question? That's the one we all want to know.

00:31 So let's take the information we just talked about and let's walk through these big three.

00:36 Ready? All right, number one.

00:39 So when we're thinking about post streptococcal glomerulonephritis, why does a nurse need to know this? Well, you need to know this because we need to identify that strep infection early because we want to make sure that they get treatment they might get the right antibiotics that they need and hopefully prevent the progression of the infection turning into PSGN.

01:01 Remember patients with strep or impetigo at risk to develop it.

01:04 So we want to be on the lookout when we're taking care of these patients or when that's diagnosed because remember glomerulonephritis equals decreased kidney function and a lower GFR, a lower glomerular filtration rate.

01:19 Okay, so why do we need to know this information? Because you need to know what to watch for.

01:26 In a test question, but most importantly in real life patients.

01:31 Now number 2.

01:32 How does it help me keep a patient safe? See these are the key questions to ask yourself to check your learning on any topic.

01:40 I'm showing you how to do it on acute glomerulonephritis, but you can add this to any of your topics.

01:46 So how does me learning about this particular type of glomerulonephritis help me keep a patient safe? Well, I can educate the patient or their parents or family or caregivers to let them know to be on the lookout for this we want them to know the signs to watch for after strep so they can get help if the patient is having some pretty significant signs.

02:11 So what things would we teach a patient? Well as we teach anybody who's taken antibiotic take the complete course of the antibiotics just as prescribed.

02:20 Nobody likes taking medicine.

02:23 So people take an antibiotic they start feeling better and so they think man I'm not even going to mess with that.

02:28 I feel fine.

02:29 Wrong not a good plan, Right? So that helps us develop resistance, which we don't want because resistance makes superbugs like MRSA and VRE and all those other ones we have and they might not completely knock out that infection.

02:43 So educate all of your patients no matter what the infection is to make sure they take the complete dose of antibiotics Now personal hygiene, you wouldn't think we need to explain this to people but we really do especially the ones with skin lesions.

03:00 If they're putting on a topical ointment would be better for them to wear gloves and then throw those gloves away and wash their hands that would be better than just putting it on with their finger and definitely wash their hands after that.

03:14 So we want to remind them that hygiene will help not spread that infection and we want them to know the signs and symptoms of glomerulonephritis.

03:22 All right? Those are the big three and knowing how does it help me keep a patient safe.

03:28 It's all about educating, take your medicines as prescribed.

03:31 Please be really careful of personal hygiene and you don't want the little one around other children until they've been on antibiotics for a little while and you want them to know the signs and symptoms of glomerulonephritis.

03:44 Now, this is my worst nightmare when I see this kind of stuff my brain just goes on overload.

03:50 I've got like what a big old list of five medical terms.

03:55 This is just boring.

03:57 So let me show you some ways that you can remember this information? It's a strategy called chunking.

04:03 Now it doesn't sound very scientific but it's research-based.

04:07 We used to think that you could remember seven items.

04:10 Yeah, now we know it's really just about four at the max.

04:13 So what we need to do is look for relationships in these answers so we can remember them and what we want to watch for as far as signs of developing glomerulonephritis.

04:24 Now by the way, these are signs for anybody whose kidney is struggling, right? Now glomerulus is real important part of your kidneys.

04:32 So anyone whose kidneys are struggling are going to show you some of these signs.

04:37 Ready? All right, let's make this list go away and we'll start breaking it down one by one.

04:43 So you would assess your patient for signs of glomerulonephritis, which we know equals decreased kidney function and a lower GFR.

04:53 So think what do you know? Let's start with normal.

04:56 What do healthy kidneys do? All right, we know they remove waste and extra water and make urine, cool! and they filter the blood so they remove waste and extra water and they filter the blood.

05:09 So as I'm studying and I'm learning and I'm walking through this I always know if I'm starting with a disease that affects an organ system, First, I do a quick review.

05:20 What do healthy organs do? So healthy kidneys remove waste and extra water make urine and they filter the blood.

05:29 You need to be solid on that point before we can look at what the problems are when it isn't functioning now.

05:35 Now I would recommend you have our notes which are pretty helpful, but it's really important that you write this out or draw this out in a way that makes sense to you what your brain has to do the mental gymnastics that your brain has to do to decide what you're going to write down.

05:51 Don't just copy what we have put it in your own words that will help encode the information in your brain so you can remember it when your taking a test and what we really care about when you're taking care of patients.

06:04 All right, so we know glomerulonephritis is decreased kidney function.

06:08 We know what healthy kidneys do.

06:11 So we know if I have glomerulonephritis.

06:13 These things aren't working that well, right? So what happens if I can't get rid of extra water and I don't make your in very well, right and I don't filter the blood.

06:24 Well, here's what happens if I can't remove the extra water.

06:28 I'm going to have a Edema.

06:29 That is extra fluid on board. Right? I have more fluid than my body needs.

06:35 What does it look like? Well, sometimes my legs will get really swollen or I'm going to be if I put my finger if I put my thumb over a shin bone and when I let my thumb up I have that divot that is pitting edema.

06:49 So why do I have edema? I have extra water on board because my kidneys aren't functioning well can't get rid of it.

06:56 Now hypertension.

06:57 Oh, why do we put these two together? Because extra fluid on board means there's extra volume in my intravascular space.

07:06 That's just a fancy word for in my vessels right? In my arteries in my veins.

07:11 I got extra fluid because my kidneys can't get rid of it.

07:14 Therefore my blood pressure goes up.

07:17 So because I know it can't remove extra water I'm going to have Edema and hypertension.

07:22 Because I can't make urine.

07:24 Hey, there's where those fancy things come from.

07:27 Oliguria means can't Olig means scant "uria" means urine.

07:33 So if these are words that are new to you, make sure you write in your notes Olig scant, uria urine.

07:39 Now Hematuria.

07:41 He met refers to blood urea again as urine.

07:45 Proteinuria is protein in your urine and that's when they're not making urine well, there's not going to be very much of it and it might look kind of weird to have blood in it or protein which you can't necessarily see the protein unless there's a whole lot of it and then It gets kind of frothy, but you may not be able to see it.

08:03 Okay, we know glomerulonephritis is a kidney that's not working well.

08:07 So we know the ways of healthy kidney works, we've looked at the the ways they do that remove waste extra water make urine.

08:15 When they can't do that they end up with Edema hypertension.

08:19 We also have some weird-looking urine and not very much of it.

08:23 Now it also filters the blood a kidney that's taken a hit kind of limping along.

08:29 It can't filter or remove very efficiently.

08:31 So I'm going to end up with a lot of extra stuff in my blood that I don't necessarily want.