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Thursday October 25, 1015-1215

W1 (English) Cultural Competence & Safety in Cree Territory: A How-to

Kahá:wi Jacobs, PhD, Programming and Planning Research Officer (PPRO) in Maanuuhiikuu, Regional Mental Health Program, Cree Board of Health and Social Services of James Bay (CBHSSJB)
Juliana Matoush-Snowboy, B.A., Director of Organisational Quality and Cultural Safety,Cree Board of Health and Social Services of James Bay (CBHSSJB)

In this session, we will introduce you to Cree culture and history as they relate to well-being and explore how you can work with the Cree in culturally safe ways.

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Thursday October 25, 1015-1215

W4 (English) When the Heart wins the battle and the Kidney wins the War

Maureen Leyser, RN (EC), BScN, MN-ANP, CCCN(c), PhD Student, University Hospital, London Health Sciences Centre

Introduction: Renal dysfunction, pre-existing or provoked, during acute heart failure (HF) represents frequent conditions that complicates the clinical course and therapeutic management.

A review of HF (incidence, prevalence, etiology, types) will be discussed. Common treatments and management will be reviewed which will include a strong focus on diuretics and its effects on renal function. A discussion and demonstration on how to determine volume status {hypovolemia (too wet), hypervolemia (too dry) and euvolemia (just right!)} will be reviewed. This will include the clinical pearls for any nurse to use to guide them through their clinical practice and assist them at the bedside.

An active debate between the two NPs will discuss the Pathophysiology interactions between the heart and kidneys during HF will be discussed; specially CRS. This will include the difficulty of monitoring renal dysfunction and managing decongestant (Heart and lungs) for the Cardiology and Nephrology team; both as an inpatient or outpatient setting. The role of Hemodialysis vs Peritoneal Dialysis in Left sided HF, Bi-ventricle HF or Right sided HF WITHOUT progressively or permanently damaging the kidneys will be reviewed. This is where both NPs need to know when to hand over or toss the baton to each other during patient management.

Finally, a brief discussion on the role of ACE-I/ARB in CRS. When to start…stop…restart.

Conclusion: A HF patient is complex with multiple organ involvement. It requires all hands-on deck and not working in silos! Therefore, HF causing CRS cannot be managed by one discipline. It must be done in collaboration by having both Cardiology and Nephrology team members engaged at all times to improve patient outcomes.