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Abstract
Introduction: Coronavirus infection favours the development of respiratory disorders. In kidney transplant patients, the prognosis of SARS-CoV-2 pneumonia may be different from the rest of the population. Many transplant patients have drug-induced lymphopenia, so early detection and treatment are crucial in this population group.
Case description: A 50-year-old man with unknown CKD and a kidney transplant in 2016 who came to the emergency room due to fever of 38ºC, cough, rhinorrhea, diarrhea with weight loss and discomfort in a kidney graft in the right iliac fossa. He was diagnosed with COVID-19 positive after performing a chest X-ray and SARS-CoV-2 PCR. He was admitted to our kidney transplant unit.
Description of the care plan: An initial assessment was made using Gordon's functional patterns. Subsequently, we identify Nursing Diagnoses according to the NANDA taxonomy with their corresponding outcome and intervention criteria.
Evaluation of the care plan: After carrying out the interventions and evaluating the outcome indicators, we observed a decrease in body temperature and respiratory distress with improvement in the respiratory pattern. Regarding renal function, it has not been significantly altered despite the temporary withdrawal of immunosuppression.
Conclusion: The patient is discharged with a renal function similar to the previous one and with reintroduced immunosuppression. The objectives set were achieved, making it clear that the role of nursing has been vital in the process of recovery and coping with the disease.
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References
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- Naicker S, Yang C, Hwang S, Liu B, Chen J, Jha V. The Novel Coronavirus 2019 epidemic and kidneys. Kidney Int. 2020 May;97(5):824-8.
- Albas Gómez-Beltrán P, Domínguez Carranza E, Medero Rubio F, Pérez Márquez M. Recomendaciones para el manejo del paciente con enfermedad renal crónica ante el SARS-CoV-2. Enferm Clin. 2020 May [En prensa].
- Fernández-Ruiz, Andrés A, Loinaz C, Delgado JF, López-Medrano F, San Juan R et al. COVID-19 in solid organ trasplant recipients: A single-center case series from Spain. Am J Transplant. 2020 Jul;20(7):1849-58.
- Coll E, Gayoso J, Martínez JR, Domínguez-Gil B. Informe casos Covid-19 en pacientes trasplantado. Organización Nacional de Trasplantes. 18 Mayo 2020. [Consultado 6 Ago 2020]. Disponible en: https://www.seden.org/files/news/INFORME%20CASOS%20COVID%2019%20EN%20PACIENTES%20TRASPLANTADOS%20%2018%20MAYO_b5f4.pdf.
- Arbilaga A, Pardás M, Escudero R, Rodriguez R, Alcaraz V, Llanes S et al. Fisioterapia respiratoria en el manejo del paciente con COVID-19: Recomendaciones general. Área de fisioterpia respiratoria. Sociedad Española de Neumología y Cirugía Torácica. SEPAR. 26 Marzo 2020. [Consultado 5 Ago 2020]. Disponible en: http://svmefr.com/wp-content/uploads/2020/03/COVID19-SEPAR-26_03_20.pdf.
References
Coronavirus disease (COVID-19) pandemic. World Health Organization. [Consultado 3 jun 2020]. Disponible en: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.
Ministerio de Sanidad. Actualización nº 177. Enfermedad por el coronavirus (COVID-19). [Consultado 4 Ago 2020]. Disponible en: https://www.mscbs.gob.es/en/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/Actualizacion_177_COVID-19.pdf.
Instituto de Salud Carlos III. Vigilancia de los excesos de mortalidad por todas las causas: MoMo. 19 Julio 2020 [Consultado 5 ago 2020]. Disponible en:https://www.isciii.es/QueHacemos/Servicios/VigilanciaSaludPublicaRENAVE/EnfermedadesTransmisibles/MoMo/Documents/informesMoMo2020/MoMo_Situacion%20a%2019%20de%20julio_CNE.pdf.
Houlshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H et al. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med. 2020;382(10):929-36.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-9.
Mo P, Xing Y, Xiao Y, Deng L, Zhao Q, Wang H et al. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan, China. Clin Infect Dis. 2020 Mar 16:ciaa270. [En prensa].
López V, Vázquez T, Alonso-Titos J, Cabello M, Alonso A, Beneyto I et al. Recomendaciones en el manejo de la pandemia por coronavirus SARS-Cov-2 (Covid-19) en paciente con trasplante renal. Nefrología 2020;40(3):265-71.
Sequera Ortiz P, Quiroga B, Arriba de la Fuente G, Macía M, Salgueira M, Pino MD. Protocolo de actuación ante la epidemia de enfermedad por coronavirus en los pacientes de diálisis y trasplantados renales. Nefrología 2020;40(3):223-7.
Naicker S, Yang C, Hwang S, Liu B, Chen J, Jha V. The Novel Coronavirus 2019 epidemic and kidneys. Kidney Int. 2020 May;97(5):824-8.
Albas Gómez-Beltrán P, Domínguez Carranza E, Medero Rubio F, Pérez Márquez M. Recomendaciones para el manejo del paciente con enfermedad renal crónica ante el SARS-CoV-2. Enferm Clin. 2020 May [En prensa].
Fernández-Ruiz, Andrés A, Loinaz C, Delgado JF, López-Medrano F, San Juan R et al. COVID-19 in solid organ trasplant recipients: A single-center case series from Spain. Am J Transplant. 2020 Jul;20(7):1849-58.
Coll E, Gayoso J, Martínez JR, Domínguez-Gil B. Informe casos Covid-19 en pacientes trasplantado. Organización Nacional de Trasplantes. 18 Mayo 2020. [Consultado 6 Ago 2020]. Disponible en: https://www.seden.org/files/news/INFORME%20CASOS%20COVID%2019%20EN%20PACIENTES%20TRASPLANTADOS%20%2018%20MAYO_b5f4.pdf.
Arbilaga A, Pardás M, Escudero R, Rodriguez R, Alcaraz V, Llanes S et al. Fisioterapia respiratoria en el manejo del paciente con COVID-19: Recomendaciones general. Área de fisioterpia respiratoria. Sociedad Española de Neumología y Cirugía Torácica. SEPAR. 26 Marzo 2020. [Consultado 5 Ago 2020]. Disponible en: http://svmefr.com/wp-content/uploads/2020/03/COVID19-SEPAR-26_03_20.pdf.