Orris

Critically analyse the signs and symptoms of Acute Kidney Injury (AKI) secondary to post-infectious glomerulonephritis to inform comprehensive nursing care for Michael Thompson - 750 words Identify three patient education goals focused on AKI recovery and chronic kidney disease (CKD) prevention- 750 words Using the information from the case study, complete the attached comprehensive care plan template for handover to the Primary Healthcare Nurse - 500 words By completing this assessment task, you will: Demonstrate understanding of the pathophysiology, signs and symptoms of AKI secondary to glomerulonephritis, potential complications, and identify key nursing interventions required to ensure patient recovery Demonstrate the ability to tailor education and care planning to individual patient needs, preferences, and goals, with particular attention to preventing recurrent AKI episodes and progression to CKD. Develop an appropriate handover using the comprehensive care plan template to ensure continuity of care in the primary healthcare setting Case Scenario It is 1400 hours. You are the RN for Michael Thompson, a 28-year-old man who has been admitted to the medical ward with Acute Kidney Injury (AKI) secondary to post-infectious glomerulonephritis. Michael presented to the Emergency Department three days ago with severe fatigue, reduced urine output, facial and peripheral oedema, and dark-coloured urine. He reported having a throat infection approximately two weeks prior, which he did not seek treatment for at the time. On admission, Michael's investigations revealed: Serum creatinine: 380 µmol/L (baseline 85 µmol/L) eGFR: 18 mL/min/1.73m² (previously >90 mL/min/1.73m²) Urinalysis: Haematuria, proteinuria (3+), red cell casts Blood pressure: 165/98 mmHg Serum potassium: 5.8 mmol/L Fluid status: Positive fluid balance of +2.5L over 48 hours Michael has responded well to conservative management over the past three days, including fluid restriction, diuretic therapy, dietary modifications (low sodium, potassium restriction), and antihypertensive therapy. His renal function is showing early signs of improvement, with serum creatinine now at 280 µmol/L, eGFR now 30 mL/min/1.73m² and urine output increasing to 1200mL over the past 24 hours. Current Status Pain Management: Michael reports mild flank discomfort, controlled with paracetamol Medications: Antihypertensive therapy (ACE inhibitor commenced) Diuretic therapy (furosemide) ceased as Miachel’s fluid balance has stabilised Sodium bicarbonate for mild metabolic acidosis Calcium resonium ceased (potassium now 5.2 mmol/L) Fluid Management: Strict fluid restriction (1.5L/24 hours)- reviewed by nephrologist given improving urine output. Patient to maintain oral fluid intake of 2L/day post-discharge unless otherwise advised by GP/nephrologist. Vital Signs: BP 142/88 mmHg; HR 78 bpm; RR 16; SpO₂ 98% on room air; Temp 36.8°C Renal Function: Improving trend - creatinine decreasing, eGFR improving, urine output increasing Diet & Activity: Renal diet (low sodium, potassium restricted); mobilising with assistance; bowels regular Discharge Planning: Michael is medically stable for discharge and will be collected by his wife at 5:30pm. Follow-up appointment with GP in 5 days for renal function review (UEC, eGFR), blood pressure monitoring, and medication review. Nephrology outpatient appointment arranged for 4 weeks post-discharge. You are to prepare Michael for discharge. This entails ensuring he understands his follow-up care, the importance of ongoing monitoring, answering any questions he may have, and providing a written care plan to the Primary Healthcare Nurse in advance of Michael's follow-up appointment in five days' time. You are required to complete the attached care plan template and email it to the Primary Healthcare Clinic prior to your shift finishing at 9pm, so it is available in the Practice tomorrow morning. You tell Michael you will be preparing his care plan for the primary healthcare nurse that evening. He says, "That's good to know - I'm worried about my kidneys. Will they go back to normal? And what do I need to do to make sure this doesn't happen again?" Assessment Task Instructions Your assessment task has three (3) components. 1. Critical Analysis of AKI Secondary to Post-Infectious Glomerulonephritis (750 words) Critically analyse and prioritise the appropriate medical and nursing management strategies used in Michaels’ AKI secondary to post infectious glomerulonephritis. a. Analyse Michael's presenting symptoms of AKI and appraise the medical management strategies for each symptom. Evaluate the pharmacological and non-pharmacological management strategies for each symptom, with particular attention to: Explain Michael's presenting symptoms and why they are occurring Critically evaluate the timing, risks and benefits of pharmacological and non-pharmacological therapies initiated during AKI management and recovery Discuss the importance of early recognition and management of AKI complications (fluid overload, electrolyte imbalances, hypertension) 2. Post-AKI Patient Education (750 words) Demonstrate understanding of recovery from AKI and prevention of CKD by providing Michael with patient-centred education: b. Identify and explain three priority nursing education interventions that Michael requires following his AKI episode. For each intervention, describe the specific information he needs for both immediate recovery and long-term renal health management. c. Support your selected education interventions with evidence from current nursing practice guidelines and research related to post-AKI care and CKD prevention, explaining why each intervention is essential for Michael's recovery and long-term wellbeing. 3. Nursing Comprehensive Care Plan (500 words) Complete the Nursing Comprehensive Care Plan Template below (attached) for handover to Michael's Primary Healthcare Nurse, who works as a practice nurse at his GP clinic, upon discharge following AKI: Comprehensive Care Plan Registered Nurse Name: Date: Patient Name: Patient Medical Diagnosis: E3 - Risk assessment (risk screening – disease or injury, risk assessment – ID risk of harm and mitigation strategies) E4 - Interventions (Prioritised - List nursing or collaborative interventions with rationale for each goal and risk) E5 - Multidisciplinary team (roles and responsibilities) E6 - Evaluation and Replanning (Were the goals met? What is new with the patient’s case) Should be presented as Person-centred goals Clinical goals Organisational goals Mitigation strategies: Organisational: Should be presented as Person-centred goals Clinical goals Organisational goals Person centred care: Goals/ Interventions: Rationale: New assessment Clinical goals: Personal: New interventions: Organisational: Criteria For marking. 1. Critical analysis of AKI secondary to post-infectious glomerulonephritis and nursing management 2. Post AKI patient education 3. Comprehensive care plan

Reading File
Finding Sources
Finding Sources
Finding Sources
Searching PubMed

"acute kidney injury" AND "nursing management"

Searching PubMed

"acute kidney injury" AND "chronic kidney disease" AND prevention

Searching the Web

KDIGO AKI follow-up guidelines patient education CKD prevention post-infectious glomerulonephritis

1. Critical Analysis of AKI Secondary to Post-Infectious Glomerulonephritis (Michael Thompson)

Pathophysiology underpinning the presentation

Michael's post-infectious glomerulonephritis (PIGN) followed an untreated streptococcal throat infection two weeks prior. Circulating immune complexes (antigen-antibody) deposit in the glomerular basement membrane, triggering complement activation and an inflammatory response that damages the capillary loops (Campbell-Walsh Wein Urology; Symptom to Diagnosis, 4th ed.). This produces the classic nephritic picture seen on admission: haematuria, proteinuria, red cell casts, hypertension and AKI - exactly what Michael presented with.
Dark (cola-coloured) urine and haematuria reflect red blood cells and RBC casts passing through damaged glomerular capillaries into the tubular lumen - a specific marker of glomerular (rather than tubular or post-renal) injury.
Reduced urine output and rising creatinine (380 µmol/L, eGFR 18 mL/min/1.73m²) occur because glomerular inflammation reduces the filtration surface area and glomerular capillary permeability, dropping GFR acutely. This is consistent with KDIGO Stage 3 AKI, reflecting severe loss of filtration capacity.
Facial and peripheral oedema, positive fluid balance (+2.5L/48h), and hypertension (165/98 mmHg) result from sodium and water retention secondary to reduced GFR, compounded by activation of the renin-angiotensin-aldosterone system (RAAS) as the kidney senses reduced perfusion. This is a volume-mediated hypertension, distinct from essential hypertension, and is critical to recognise because aggressive fluid administration would worsen it.
Hyperkalaemia (5.8 mmol/L) reflects reduced renal potassium excretion, an emergency requiring rapid recognition due to the risk of life-threatening arrhythmia.
Fatigue is multifactorial: uraemic toxin accumulation, electrolyte disturbance, and poor sleep/oedema-related discomfort.

Evaluation of management strategies

Non-pharmacological - fluid restriction (initially strict, now 1.5L/24h, easing to 2L/day): appropriately initiated early in the oliguric phase to prevent pulmonary oedema and hypertensive crisis. The benefit is direct control of preload and BP; the risk is under-perfusion or dehydration if restriction is not relaxed as diuresis returns - which is exactly why the nephrologist reviewed and liberalised Michael's fluid allowance as his urine output climbed to 1200 mL/24h. This demonstrates good practice: fluid orders in AKI must be dynamic, not fixed, and reassessed against trend data (Comprehensive Clinical Nephrology, 7th ed.).
Diuretic therapy (furosemide): used to offload the +2.5L fluid excess and assist potassium excretion. Timing was appropriate to the congested phase; ceasing it once fluid balance stabilised was correct, as continued use risks hypovolaemia, worsening pre-renal injury on top of the intrinsic glomerular injury, and electrolyte derangement (hypokalaemia, hyponatraemia, ototoxicity at high doses).
Antihypertensive therapy (ACE inhibitor): provides dual benefit - systemic BP control and reduction of intraglomerular pressure, which is renoprotective and reduces proteinuria long-term. However, ACE inhibitors can acutely lower GFR and elevate potassium, so their initiation required Michael's potassium to first be trending down (5.2 mmol/L) and close UEC monitoring afterwards - illustrating the importance of sequencing therapy against biochemistry rather than treating BP in isolation (Brenner and Rector's The Kidney; Goldman-Cecil Medicine).
Potassium management (calcium resonium, dietary restriction): calcium resonium was appropriately time-limited - ceased once potassium normalised to 5.2 mmol/L - because prolonged use risks constipation, bowel necrosis and sodium loading. Dietary potassium restriction remains the safer, sustained non-pharmacological strategy.
Sodium bicarbonate: corrects the metabolic acidosis arising from reduced renal acid excretion; evidence supports bicarbonate therapy slowing progression of renal impairment, but it must be balanced carefully against fluid/sodium restriction goals.
Analgesia: paracetamol for flank discomfort was the correct choice; NSAIDs must be avoided as they reduce renal prostaglandin-mediated perfusion and can worsen AKI - an essential nursing safety check.

Early recognition of complications

The three highest-priority complications - fluid overload, hyperkalaemia and hypertension - are all immediately life-threatening and interrelated. Nursing priorities include strict fluid balance charting and daily weights (fluid overload/pulmonary oedema), continuous ECG or serial potassium monitoring with rapid escalation for arrhythmic changes (hyperkalaemia), and regular BP monitoring with attention to hypertensive encephalopathy or accelerated nephron loss (hypertension). Literature confirms AKI accelerates progression to CKD and end-stage kidney disease if complications are not promptly identified and treated (Realista, 2022, Critical Care Nursing Clinics of North America; Clare, 2022, Nursing Standard), reinforcing that vigilant nursing assessment during the acute phase directly influences Michael's long-term renal trajectory.

2. Post-AKI Patient Education for Michael

Michael has directly asked: "Will my kidneys go back to normal? What do I need to do to make sure this doesn't happen again?" This frames three priority education interventions.

Education Goal 1: Understanding follow-up monitoring and recognising deterioration

Michael needs to understand that recovery is monitored via serial serum creatinine, eGFR and urinalysis, not by how he feels. His GP review in 5 days (UEC, eGFR, BP, medication review) and nephrology follow-up at 4 weeks are not optional extras but are central to detecting whether he is progressing towards full recovery or acute kidney disease (AKD)/CKD. KDIGO's 2024/2026 guidance explicitly recommends structured post-AKI surveillance with an identified follow-up clinician and clear inpatient-to-outpatient communication, precisely the handover this care plan provides. He should be taught to self-monitor BP at home, keep a simple log of weight and urine output/colour, and know red-flag symptoms warranting urgent review: return of dark urine, decreasing urine output, new or worsening swelling, breathlessness, or severe headache. This matters immediately (his creatinine is still 280 µmol/L, not yet normal) and long-term, because a systematic review (Wang et al., 2025, PMID 40890538) confirms AKI survivors carry a persistently elevated risk of progression to CKD, cardiovascular events and recurrent AKI, meaning surveillance cannot stop once he "feels better."

Education Goal 2: Renal-protective diet, fluid balance and medication safety

Michael must understand why he is on a low-sodium, potassium-restricted diet and why fluid intake is being liberalised, not because restriction is punitive, but because his kidneys are still recalibrating their handling of sodium, potassium and water. He should continue low-sodium eating to support BP control and reduce oedema recurrence, while maintaining the advised 2L/day oral fluid intake unless his GP or nephrologist changes this. Critically, he must be educated on nephrotoxic medication avoidance - particularly NSAIDs (ibuprofen, diclofenac), which are freely available over the counter and can precipitate further nephron injury - and told to inform any future prescriber, dentist, or radiology service of his AKI history before receiving contrast dye or new medications. This is supported by KDIGO's emphasis on medication optimisation as a core component of post-AKI kidney health protection, and is essential because recurrent nephrotoxic insults compound cumulative renal damage and hasten CKD onset.

Education Goal 3: Prompt treatment of infection and adherence to antihypertensive therapy

Because Michael's AKI was triggered by an untreated streptococcal throat infection, he needs explicit education that future sore throats, skin infections or other infections should be assessed and treated promptly rather than left, as recurrent immune-complex-mediated glomerular injury is the primary mechanism for repeat episodes and CKD progression. He should also understand the rationale for his ACE inhibitor: not just BP control, but reduction of intraglomerular pressure and proteinuria, both of which slow long-term renal decline. Non-adherence or abrupt cessation risks rebound hypertension and accelerated glomerular injury. KDIGO's 2024 CKD guideline stresses that effective self-management education must be patient-centred, plain-language, and cover disease knowledge, treatment rationale and complication prevention - which is exactly the framing used here to answer Michael's question about recurrence prevention.
Together, these three interventions directly answer Michael's stated concerns: his kidneys are recovering (trending eGFR and creatinine confirm this) but "back to normal" depends on sustained surveillance, renal-protective behaviour, and prompt infection treatment - the modifiable factors within his control.

3. Comprehensive Care Plan - Handover to Primary Healthcare Nurse

FieldDetail
Registered Nurse Name[RN name]
Patient NameMichael Thompson
E3 - Risk Assessment
  • Risk of recurrent AKI/progression to CKD (evidence confirms elevated long-term risk post-AKI).
  • Risk of undetected deterioration in renal function if follow-up missed.
  • Risk of rebound hypertension/hyperkalaemia if antihypertensive or dietary adherence lapses.
  • Risk of nephrotoxic exposure (NSAIDs, contrast media) worsening residual injury.
  • Risk of recurrent PIGN from untreated future infections.
Mitigation strategies: Person-centred: address Michael's anxiety about "returning to normal" with clear, honest information; involve his wife in education. Clinical: GP-led UEC/eGFR/BP review in 5 days; nephrology review at 4 weeks; home BP monitoring. Organisational: GP practice to flag Michael's file for renal recall/reminder system; ensure care plan received before appointment.
E4 - Interventions (prioritised, with rationale)
  1. Repeat UEC, eGFR, urinalysis at GP visit - rationale: track resolution vs progression to AKD/CKD.
  2. Review ACE inhibitor dose/tolerance and potassium - rationale: balance renoprotection against hyperkalaemia risk.
  3. Reinforce low-sodium diet, 2L/day fluid target, NSAID avoidance - rationale: minimise further renal insult.
  4. Educate on infection vigilance and prompt treatment-seeking - rationale: prevent recurrent immune-mediated injury.
  5. Confirm nephrology outpatient appointment attendance (4 weeks) - rationale: specialist oversight of recovery trajectory.
E5 - Multidisciplinary Team
  • GP: medication review, biochemistry monitoring, coordination of referrals.
  • Practice Nurse: BP checks, education reinforcement, recall system.
  • Nephrologist: specialist renal function review, long-term surveillance.
  • Dietitian (as needed): reinforce renal diet as function changes.
  • Pharmacist: medication reconciliation, nephrotoxic drug screening.
E6 - Evaluation and Replanning
  • Clinical goals: eGFR/creatinine trending towards baseline; BP within target; potassium stable.
  • Personal goals: Michael verbalises understanding of red-flag symptoms and follow-up schedule; reports confidence managing diet/fluids.
  • Organisational goals: GP clinic confirms receipt of care plan prior to appointment; recall system activated.
  • New assessment/interventions: if renal function has not improved or has worsened at 5-day review, escalate to nephrology urgently rather than waiting for the 4-week appointment; reassess antihypertensive regimen and dietary restrictions accordingly.

Create a Word document summary of post-AKI care for Michael's take-home information

Reading File
Running Command

mkdir -p /tmp/workspace/michael-thompson-aki && ls -la /tmp/workspace/

Writing File

~/michael-thompson-aki/build_doc.py

from docx import Document
from docx.shared import Pt, Inches, RGBColor
from docx.enum.text import WD_ALIGN_PARAGRAPH
from docx.enum.table import WD_TABLE_ALIGNMENT
from docx.oxml.ns import qn
from docx.oxml import OxmlElement

NAVY = RGBColor(0x1F, 0x3B, 0x57)
TEAL = RGBColor(0x0E, 0x6E, 0x6E)
RED = RGBColor(0xB0, 0x2A, 0x2A)
GREY = RGBColor(0x55, 0x55, 0x55)

doc = Document()

# Default styling
normal = doc.styles["Normal"]
normal.font.name = "Calibri"
normal.font.size = Pt(11)

sections = doc.sections
for s in sections:
    s.left_margin = Inches(0.8)
    s.right_margin = Inches(0.8)
    s.top_margin = Inches(0.7)
    s.bottom_margin = Inches(0.7)

def shade_cell(cell, hex_color):
    tcPr = cell._tc.get_or_add_tcPr()
    shd = OxmlElement('w:shd')
    shd.set(qn('w:val'), 'clear')
    shd.set(qn('w:fill'), hex_color)
    tcPr.append(shd)

def set_cell_text(cell, text, bold=False, color=None, size=11, align=None):
    cell.text = ""
    p = cell.paragraphs[0]
    if align:
        p.alignment = align
    run = p.add_run(text)
    run.bold = bold
    run.font.size = Pt(size)
    if color:
        run.font.color.rgb = color

def add_heading_bar(text, color=NAVY, size=15):
    p = doc.add_paragraph()
    p.paragraph_format.space_before = Pt(14)
    p.paragraph_format.space_after = Pt(6)
    run = p.add_run(text)
    run.bold = True
    run.font.size = Pt(size)
    run.font.color.rgb = color
    # bottom border
    pPr = p._p.get_or_add_pPr()
    pBdr = OxmlElement('w:pBdr')
    bottom = OxmlElement('w:bottom')
    bottom.set(qn('w:val'), 'single')
    bottom.set(qn('w:sz'), '6')
    bottom.set(qn('w:space'), '1')
    bottom.set(qn('w:color'), '1F3B57')
    pBdr.append(bottom)
    pPr.append(pBdr)
    return p

def bullet(text, bold_lead=None):
    p = doc.add_paragraph(style="List Bullet")
    if bold_lead:
        r = p.add_run(bold_lead)
        r.bold = True
        p.add_run(text)
    else:
        p.add_run(text)
    return p

# ---------- TITLE BLOCK ----------
title_p = doc.add_paragraph()
title_p.alignment = WD_ALIGN_PARAGRAPH.CENTER
r = title_p.add_run("Going Home After Acute Kidney Injury (AKI)")
r.bold = True
r.font.size = Pt(22)
r.font.color.rgb = NAVY

sub_p = doc.add_paragraph()
sub_p.alignment = WD_ALIGN_PARAGRAPH.CENTER
r = sub_p.add_run("Your Take-Home Guide to Recovery")
r.italic = True
r.font.size = Pt(13)
r.font.color.rgb = TEAL

info_p = doc.add_paragraph()
info_p.alignment = WD_ALIGN_PARAGRAPH.CENTER
r = info_p.add_run("Prepared for: Michael Thompson   |   Discharge Date: [insert date]")
r.font.size = Pt(10)
r.font.color.rgb = GREY

doc.add_paragraph()

# Intro box
intro = doc.add_table(rows=1, cols=1)
intro.alignment = WD_TABLE_ALIGNMENT.CENTER
cell = intro.rows[0].cells[0]
shade_cell(cell, "EAF2F2")
cell.text = ""
p = cell.paragraphs[0]
p.paragraph_format.space_before = Pt(6)
p.paragraph_format.space_after = Pt(6)
run = p.add_run(
    "Hi Michael, well done on your progress so far. Your kidneys are recovering well, and this "
    "guide brings together everything we discussed before you left hospital. Keep it somewhere "
    "handy and bring it to your GP and nephrology appointments."
)
run.font.size = Pt(11)
run.italic = True

# ---------- SECTION 1: WHAT HAPPENED ----------
add_heading_bar("1. What Happened to Your Kidneys")
doc.add_paragraph(
    "You were admitted with Acute Kidney Injury (AKI) caused by post-infectious glomerulonephritis - "
    "this happened because your body's immune response to a throat infection about two weeks earlier "
    "affected the small filters inside your kidneys (the glomeruli). This caused swelling, high blood "
    "pressure, blood/protein in your urine, and reduced kidney function."
)
doc.add_paragraph("The good news: your kidney function has been improving steadily.")

tbl = doc.add_table(rows=3, cols=3)
tbl.style = "Light Grid Accent 1"
hdr = tbl.rows[0].cells
for i, h in enumerate(["Test", "On Admission", "Before Discharge"]):
    set_cell_text(hdr[i], h, bold=True, color=RGBColor(255,255,255))
    shade_cell(hdr[i], "1F3B57")
rows_data = [
    ("Creatinine (blood test)", "380 µmol/L", "280 µmol/L (improving)"),
    ("eGFR (kidney function)", "18 mL/min", "30 mL/min (improving)"),
]
for i, row in enumerate(rows_data, start=1):
    for j, val in enumerate(row):
        set_cell_text(tbl.rows[i].cells[j], val, bold=(j==0))

doc.add_paragraph(
    "These numbers are not yet back to your normal baseline (creatinine 85 µmol/L) but they are "
    "moving in the right direction. Full recovery can take weeks to months, and needs to be checked "
    "with blood and urine tests - not just by how you feel."
)

# ---------- SECTION 2: MEDICATIONS ----------
add_heading_bar("2. Your Medications")
mtbl = doc.add_table(rows=5, cols=2)
mtbl.style = "Light Grid Accent 1"
hdr = mtbl.rows[0].cells
set_cell_text(hdr[0], "Medication", bold=True, color=RGBColor(255,255,255))
set_cell_text(hdr[1], "What it's for / Notes", bold=True, color=RGBColor(255,255,255))
shade_cell(hdr[0], "0E6E6E"); shade_cell(hdr[1], "0E6E6E")
med_rows = [
    ("ACE inhibitor (blood pressure tablet)", "Protects your kidneys and controls blood pressure. Take exactly as prescribed - do not stop without talking to your GP."),
    ("Sodium bicarbonate", "Corrects mild acid build-up in your blood while your kidneys recover."),
    ("Paracetamol (as needed)", "For mild flank/back discomfort. Do NOT take ibuprofen, Nurofen, Voltaren or other anti-inflammatory (NSAID) painkillers - these can harm your kidneys."),
    ("Furosemide (water tablet) and calcium resonium", "These have now been STOPPED because your fluid and potassium levels have settled."),
]
for i, (a, b) in enumerate(med_rows, start=1):
    set_cell_text(mtbl.rows[i].cells[0], a, bold=True)
    set_cell_text(mtbl.rows[i].cells[1], b)

p = doc.add_paragraph()
r = p.add_run("Important: ")
r.bold = True
r.font.color.rgb = RED
p.add_run("Always tell any doctor, dentist, pharmacist or imaging service that you recently had AKI before taking a new medicine, having an X-ray with contrast dye, or starting any supplement.")

# ---------- SECTION 3: DIET & FLUIDS ----------
add_heading_bar("3. Diet and Fluids at Home")
bullet("Aim for about 2 litres of fluid per day (water, tea, etc.) unless your GP or kidney specialist tells you otherwise.", "Fluids: ")
bullet("Keep your diet low in salt - avoid adding salt to meals, and limit processed, takeaway and packaged foods.", "Low salt: ")
bullet("Continue moderating high-potassium foods (bananas, oranges, potatoes, tomatoes) until your GP confirms your potassium level is stable and this restriction can relax.", "Potassium: ")
bullet("A dietitian referral can help you move safely from a strict renal diet back to a normal healthy diet as your kidneys recover.", "Dietitian: ")

# ---------- SECTION 4: FOLLOW-UP ----------
add_heading_bar("4. Your Follow-Up Appointments")
ftbl = doc.add_table(rows=3, cols=3)
ftbl.style = "Light Grid Accent 1"
hdr = ftbl.rows[0].cells
for i, h in enumerate(["When", "Who", "What will happen"]):
    set_cell_text(hdr[i], h, bold=True, color=RGBColor(255,255,255))
    shade_cell(hdr[i], "1F3B57")
frows = [
    ("In 5 days", "Your GP / Practice Nurse", "Blood test (kidney function), urine test, blood pressure check, medication review. A full care plan has been sent to your clinic ahead of this visit."),
    ("In 4 weeks", "Kidney specialist (Nephrologist)", "Detailed review of your kidney recovery and ongoing management plan."),
]
for i, row in enumerate(frows, start=1):
    for j, val in enumerate(row):
        set_cell_text(ftbl.rows[i].cells[j], val, bold=(j==0))

doc.add_paragraph(
    "Please attend both appointments even if you are feeling completely well - hidden kidney "
    "problems can only be picked up on blood and urine tests."
)

# ---------- SECTION 5: RED FLAGS ----------
add_heading_bar("5. When to Seek Help Urgently", color=RED)
warn_tbl = doc.add_table(rows=1, cols=1)
cell = warn_tbl.rows[0].cells[0]
shade_cell(cell, "FBE7E7")
cell.text = ""
p = cell.paragraphs[0]
run = p.add_run("Contact your GP the same day, or go to your nearest Emergency Department, if you notice:")
run.bold = True
run.font.color.rgb = RED
for item in [
    "Little or no urine, or a big drop in how much you are passing",
    "Dark, tea-coloured or bloody urine returning",
    "New or worsening swelling of your face, legs or ankles",
    "Shortness of breath, especially lying flat, or chest tightness",
    "Severe headache, blurred vision, or a very high blood pressure reading at home",
    "Fever, sore throat, or a skin infection - these should be treated early and promptly, as untreated infection was the original trigger for your kidney problem",
]:
    p = cell.add_paragraph(style="List Bullet")
    p.add_run(item)

# ---------- SECTION 6: STAYING WELL LONG TERM ----------
add_heading_bar("6. Protecting Your Kidneys for the Future")
bullet("Take your blood pressure tablets as prescribed, even once you feel well - stopping suddenly can put stress back on your kidneys.", "Medication adherence: ")
bullet("If your GP gives you a home blood pressure monitor, check and record your readings as advised.", "Monitor blood pressure: ")
bullet("See a doctor promptly for any future throat or skin infection - don't 'wait it out' as you did last time. Early antibiotic treatment reduces the risk of this happening again.", "Treat infections early: ")
bullet("Avoid regular use of ibuprofen and other NSAID painkillers, stay within safe paracetamol doses, and check with your pharmacist before taking new over-the-counter medicines or supplements.", "Avoid kidney-harming medicines: ")
bullet("Keep up your low-sodium diet, healthy weight, regular activity as advised, and limit alcohol - all support long-term kidney and heart health.", "Healthy lifestyle: ")
bullet("Attend all scheduled blood tests and specialist reviews, even after you feel 100% recovered, so any early signs of chronic kidney disease can be caught and managed.", "Stay engaged with follow-up: ")

# ---------- SECTION 7: QUESTIONS ANSWERED ----------
add_heading_bar("7. Answering Your Questions")
p = doc.add_paragraph()
r = p.add_run('"Will my kidneys go back to normal?" ')
r.bold = True
p.add_run(
    "Your results are already improving well. Many people recover most or all of their kidney "
    "function after this type of kidney inflammation, but it can take weeks to months, and needs "
    "to be confirmed with follow-up blood tests rather than assumed."
)
p = doc.add_paragraph()
r = p.add_run('"What do I need to do to stop this happening again?" ')
r.bold = True
p.add_run(
    "Treat throat and skin infections promptly, take your medications as prescribed, keep your "
    "follow-up appointments, avoid kidney-harming painkillers, and stick to the diet and fluid "
    "advice above. These steps give your kidneys the best chance of full recovery and protect "
    "you against future kidney problems."
)

doc.add_paragraph()
foot = doc.add_paragraph()
foot.alignment = WD_ALIGN_PARAGRAPH.CENTER
r = foot.add_run("If you have any questions before your next appointment, contact your GP clinic or the renal ward.")
r.italic = True
r.font.size = Pt(9)
r.font.color.rgb = GREY

doc.save("/tmp/workspace/michael-thompson-aki/Michael_Thompson_Post-AKI_Take-Home_Guide.docx")
print("saved")
Running Command

cd /tmp/workspace/michael-thompson-aki && python3 build_doc.py

Running Command

cd /tmp/workspace/michael-thompson-aki && python3 -c " from docx import Document doc = Document('Michael_Thompson_Post-AKI_Take-Home_Guide.docx') print('paragraphs:', len(doc.paragraphs)) print('tables:', len(doc.tables)) " && ls -la

Document created successfully. It's a patient-friendly take-home guide (plain language, no jargon) covering:
  1. What happened to your kidneys - simple explanation of AKI/glomerulonephritis with a before/after results table
  2. Medications - what each one does, what's been stopped, NSAID warning
  3. Diet and fluids - 2L/day fluid target, low salt, potassium caution, dietitian note
  4. Follow-up appointments - GP in 5 days, nephrology in 4 weeks, in table format
  5. Red flags - highlighted in red, when to seek urgent help
  6. Protecting your kidneys long term - medication adherence, prompt infection treatment, avoiding nephrotoxic drugs, lifestyle
  7. Direct answers to Michael's own questions ("will my kidneys go back to normal?" / "how do I stop this happening again?")

Michael Thompson Post AKI Take Home Guide

Word Document · DOCX

Let me know if you'd like the clinic name/discharge date filled in, or a shorter one-page version for printing.
This is a shared conversation. Sign in to Orris to start your own chat.