Hemolytic Uremic Syndrome (HUS) for the RPN

Hemolytic uremic syndrome (HUS; haemolytic uraemic syndrome) is a serious illness that usually follows bloody diarrhoea caused by Shiga toxin-producing E. coli (STEC), most often E. coli O157:H7. It affects mainly children under 5 years of age and is a leading cause of sudden kidney failure in young Canadian children. STEC infection is a notifiable disease, so public health follows every case. HUS is made up of three problems occurring together: - Hemolytic anaemia: red blood cells break apart in damaged small vessels. - Thrombocytopenia: platelets are used up in tiny clots. - Acute kidney injury: the kidneys suddenly filter poorly, so urine output falls and fluid, potassium and waste build up. Active HUS can rapidly become complex, unstable and unpredictable; assign and reassess care according to client needs, nurse competence, available supports and provincial standards, with RN/prescriber consultation and escalation. The RPN may care for a child whose condition has stabilized, may contribute to care as part of the team, and often meets these children in clinics, community settings and during recovery. In every setting, the RPN recognizes early...