NRS 410 Discuss the nurse’s role in supporting the patient’s psychological and emotional needs

NRS 410 Discuss the nurse’s role in supporting the patient’s psychological and emotional needs

NRS 410 Discuss the nurse’s role in supporting the patient’s psychological and emotional needs

Positive and negative psychological attitudes affect the waste elimination processes. Stress, embarrassment, isolation, anxiety, and body image issues, hasten gastrointestinal problems. For example, studies indicate that stress increases constipation and abdominal pain syndrome (Lopresti, 2020). This restricts bowel movement, limiting waste elimination processes. However, communication, education, and support from family and nurses ease bowel movements, increasing the waste elimination process. A positive attitude towards gastrointestinal issues can improve the waste elimination procedures such as bladder and bowel movements. Empathy towards the patients can decrease any irregularities in the waste elimination lifecycles.


Lopresti, A. L. (2020). The effects of psychological and environmental stress on micronutrient concentrations in the body: a review of the evidence. Advances in Nutrition11(1), 103-112.

Elimination complexities are conditions that interfere with the normal excretion process of the body. There are several elimination structures in the human body including the pancreas, gastrointestinal systems renal and biliary structures. When these structures fail to function effectively they result to problems in the excretion system thereby resulting to elimination complexities. Uremia is an example of elimination disorder which occurs when kidney fails to filter toxins in urine. Elimination complexities affect the lives of the patient and their families greatly. Apart from the physical health impacts the condition has on patients, elimination complexities also lead to psychological and emotional stress (Castellan et al., 2016). Studies show that families and patients with end-stage renal disease experience psychological financial and emotional stress.

The severity and extent of the complexity differs from person to person depending also on the structure being affected. Some complexities are associated with symptoms that may limit patients’ interaction in social place due to fear of stigma. Families are faced with psychological stress seeing their loved ones in the condition. All these lead to anxiety and depression (Sharma &Bhutta, 2022). In addition to that, families may stress out due to high financial costs needed for treatment and symptoms management. Nurses play a great role in supporting patients with elimination problem. Emotionally, nurses can hold conversations with the patients allowing the patient to express how they feel about their condition. In the conversations, nurses can instill hope by educating the patient on their condition and providing them with relevant information and data.


Castellan, C., Sluga, S., Spina, E., & Sanson, G. (2016). Nursing diagnoses, outcomes and interventions as measures of patient complexity and nursing care requirement in Intensive Care Unit. Journal of Advanced Nursing72(6), 1273-1286.

Sharma, P., & Bhutta, B. S. (2022). Assisting Patients With Elimination. In StatPearls [Internet]. StatPearls Publishing.

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Psychiatric disorders commonly co-exist with the diagnosis of ESRD. kidney disease (CKD). Research on depression and CKD is increasing a great deal. Many studies have shown that depression is more common in CKD and that end-stage renal disease is a robust risk factor for adverse effects such as hospitalization and death, but these are often underdiagnosed or untreated (Goh & Griva, 2018. When compared with the general population, patients with ESRD are five times more likely to suffer from depression. The reported rate of depression in patients with CKD ranges from 20% to 30% (Goh & Griva, 2018). As nurses, it’s important for us to take this into consideration when assessing our renal patients and assess for things like depression and anxiety, so we can further get them the help they need.

Goh, Z. S., & Griva, K. (2018). Anxiety and depression in patients with end-stage renal disease: impact and management challenges – a narrative review. International journal of nephrology and renovascular disease11, 93–102.

Elimination complexity is the medical term that defines this health condition which can be disastrous if not

NRS 410 Discuss the nurse's role in supporting the patient's psychological and emotional needs
NRS 410 Discuss the nurse’s role in supporting the patient’s psychological and emotional needs

addressed on time (Cohen, 2018). First, this condition is financially costly for patients, which implies that they will get affected economically. Treatment of some of the elimination complexities, such as urine elimination concerns, is costly (Schonberger, 2018). Some have financial assistance from family members, which also affects them financially. Also, the condition affects work attendance among working patients, thus making them suffer more economically. Besides, psychological problems such as stress, anxiety, and fear are prevalent among sick persons and their families (Schonberger, 2018).

Elimination complexes can have a variety of effects on patients and their families. Patients, for example, may feel embarrassed or ashamed of their condition, as well as isolated and alone. Families may struggle to cope with the day-to-day care of a loved one with an elimination complex. The nurse’s role in addressing the patient’s psychological and emotional needs is to offer encouragement, support, and understanding.

The daily care of a loved one with an elimination complex can be daunting and challenging for families. The nurse can help provide information about resources available to help the patient and family cope with the condition.

The challenges associated with an elimination complex can lead to feelings of isolation for families too. The nurse can also provide encouragement by sharing stories of other patients who have successfully managed their condition.



Allshouse, C., Comeau, M., Rodgers, R., & Wells, N. (2018). Families of children with medical complexity: a view from the front lines. Pediatrics141(Supplement_3), S195-S201.


Cohen, R. I. (2018). Lean methodology in health care. Chest, 154(6), 1448-1454.


Schonberger, R. J. (2018). Reconstituting lean in healthcare: From waste elimination toward ‘queue-less’ patient-focused care. Business Horizons, 61(1), 13-22.

One example of elimination complexity is chronic kidney disease. Chronic kidney disease is a progressive irreversible disease that affects the kidneys (Whitney, 2018). It has stages from 1 to 5 and progressives slowly in the beginning. Some common causes of kidney disease are hypertension, diabetes, nephrosclerosis, renal calculi, and nephrotoxins (Whitney, 2018). Kidney failure is based on glomerular filtration rate.

Nursing management and teaching for chronic kidney disease start at first treatment, during, and at discharge (Whitney, 2018). At first, the nurse needs to identify the potential toxins, nephrotoxic agents that pose a threat to patients’ renal function, and risk factors (Whitney, 2018). Some procedures that can cause the toxins due to the contrast are computed tomography, cardiac catheterization, and pacemaker implantations (Whitney, 2018). A nurse needs to get lab work to get a patient’s baseline for serum creatinine level and BUN prior to administering contrast dye (Whitney, 2018). A nurse should monitor these levels after the procedure and also to educate the patient to monitor urine output and report decrease urine output immediately.

Patients and family’s needs support with a patient with renal disease. These patients and families need emotional, psychological support to help them thru the disease process. These patients’ life will revolve around dialysis treatments, transplants, and eventually death (Whitney, 2018). These patients need encouragement and support and assistance to maintain quality of life. They need coping skills, spiritual care, education to maintain treatment plans, self-care, and physical activity (Whitney, 2018). Nurses need to help set goals for recovery and independence, support groups, and education of the disease process. These will help eliminate stress and anxiety. Nurses need to educate the patient throughout the process and promote independence.


Whitney, Stacey (2018). Pathophysiology: Clinical applications for client health. Grand Canyon University (Ed).

Elimination complexities such as kidney disease can result from treating other conditions. Chemotherapy treatments for cancer, for example, pose a risk for complications such as nephrotoxicity. Chemotherapy drugs can cause various renal and electrolyte disorders (Małyszko et al., 2017). Chemotherapy can affect the glomerulus, tubules, interstitium, or renal microvasculature—clinical manifestations range from an elevation of serum creatinine to acute renal failure requiring dialysis (Małyszko et al., 2017). Other factors can potentiate renal dysfunction contributing to nephrotoxicity of antineoplastic drugs, including the use of other nephrotoxic drugs (e.g., antibiotics, NSAIDs, radiographic contrast), urinary tract obstruction due to tumor, and other comorbidities such as diabetes, HTN, CHF, or the malignancy itself (Małyszko et al., 2017). Tumor lysis syndrome is another complication that can affect the kidneys, as the massive tumor cell lysis causes a high level of potassium, phosphate, and uric acids in the circulatory system (Małyszko et al., 2017). The early diagnosis and prompt treatment of kidney and electrolyte disorders are essential; monitoring kidney function before and during treatment is vital to identifying nephrotoxicity.

Imagine being a patient already stressed and devastated with a cancer diagnosis, then adding complications such as ARF requiring dialysis. Patients and their families will need education and emotional and spiritual support. Offering outpatient support counseling or support groups, as well as online resources for additional education, can help.


Małyszko, J., Kozłowska, K., Kozłowski, L., & Małyszko, J. (2017). Nephrotoxicity of anticancer treatment. Nephrology Dialysis Transplantation32(6), 924–936.