Dr.Justine Kiplagat.

Dr.Justine Kiplagat. Director Nursing Services, ICU Manager, Nurse educator, ICU instructor

Code blue approach
29/01/2026

Code blue approach

🩺 Signs Your Kidneys Are FailingYour kidneys act like natural filters. They clean waste from your blood, control fluid b...
23/01/2026

🩺 Signs Your Kidneys Are Failing

Your kidneys act like natural filters. They clean waste from your blood, control fluid balance, regulate blood pressure, and help keep your bones and blood healthy.
When kidneys start failing, symptoms often appear slowly and silently, which is why many people ignore them until damage becomes severe.

Below are the important warning signs:

🟣 Changes in urination
β†’ Passing urine more or less often than usual
β†’ Urinating frequently at night
β†’ Foamy or bubbly urine (sign of protein loss)
β†’ Dark, cloudy, or blood-tinged urine
β†’ Burning or difficulty while urinating

🟣 Swelling in feet, ankles, face, or hands
β†’ Kidneys fail to remove excess salt and water
β†’ Fluid collects in the body
β†’ Puffy eyes, especially in the morning
β†’ Tight shoes or rings suddenly feeling tight

🟣 Persistent fatigue and weakness
β†’ Kidneys produce a hormone needed to make red blood cells
β†’ Kidney failure causes anemia
β†’ Feeling tired even after rest
β†’ Low energy and poor concentration

🟣 Shortness of breath
β†’ Extra fluid can build up in the lungs
β†’ Anemia reduces oxygen delivery to tissues
β†’ Breathlessness on mild activity or while lying flat

🟣 Loss of appetite and nausea
β†’ Waste buildup in the blood causes nausea
β†’ Feeling full quickly
β†’ Metallic or bitter taste in the mouth
β†’ Unexplained vomiting in later stages

🟣 Persistent itching and dry skin
β†’ Waste and mineral imbalance irritate the skin
β†’ Itching without rash
β†’ Skin becomes dry, rough, or flaky

🟣 Muscle cramps and body aches
β†’ Imbalance of calcium, phosphorus, and electrolytes
β†’ Night-time leg cramps
β†’ Muscle stiffness or weakness

🟣 High blood pressure that is hard to control
β†’ Kidney disease can cause high BP
β†’ High BP further damages kidneys
β†’ A dangerous cycle if untreated

🟣 Difficulty sleeping and mental fog
β†’ Toxins affect brain function
β†’ Poor sleep quality
β†’ Trouble focusing or remembering things

🟣 Chest pain or pressure (serious sign)
β†’ Fluid buildup around the heart
β†’ Needs urgent medical attention

Why kidney failure symptoms are often missed

β†’ Symptoms develop slowly
β†’ Early signs feel β€œnormal” or age-related
β†’ Often confused with diabetes, BP, or stress
β†’ Many people do not get routine kidney tests

When to seek medical help urgently

β†’ Swelling with reduced urine output
β†’ Persistent foamy or bloody urine
β†’ Severe breathlessness or chest pain
β†’ Long-standing diabetes or high blood pressure with new symptoms

Key message

β†’ Kidney disease is silent but serious
β†’ Early detection can prevent dialysis or transplant
β†’ Simple blood and urine tests can save kidney function

⚠️ Medical Disclaimer:
This information is for educational purposes only and does not replace medical advice. If you notice persistent swelling, urine changes, breathlessness, or extreme fatigue, consult a doctor or nephrologist promptly.

🟣 How to Treat Wet Cough (Productive Cough)A wet cough is a cough that produces mucus or phlegm. It is the body’s natura...
03/01/2026

🟣 How to Treat Wet Cough (Productive Cough)

A wet cough is a cough that produces mucus or phlegm. It is the body’s natural way of clearing infections, dust, or excess secretions from the lungs and airways. Treatment focuses on loosening mucus, clearing the chest, and treating the underlying cause.

🟣 Common Causes of Wet Cough

β†’ Chest infections (common cold, flu, bronchitis, pneumonia)
β†’ Post-nasal drip due to sinus infection or allergy
β†’ Smoking or exposure to pollution
β†’ Chronic conditions like COPD or bronchiectasis

🟣 Home Remedies (First Line Support)

β†’ Warm fluids (water, soups, herbal teas)
β†’ Thin thick mucus and make it easier to cough out

β†’ Steam inhalation
β†’ Moistens airways and loosens sticky phlegm

β†’ Honey (adults & children >1 year only)
β†’ Soothes throat and reduces cough irritation

β†’ Salt-water gargling
β†’ Helps clear throat mucus and reduces irritation

β†’ Rest and adequate sleep
β†’ Allows the body to fight infection and heal faster

🟣 Medications for Wet Cough

β†’ Expectorants
β†’ Guaifenesin helps loosen and thin mucus
β†’ Makes coughing more productive and effective

β†’ Mucolytics
β†’ Acetylcysteine or ambroxol break down thick phlegm
β†’ Helpful in chest congestion

β†’ Bronchodilators (if wheezing or breathlessness present)
β†’ Open airways and help mucus clearance

β†’ Antibiotics
β†’ Only needed if a bacterial infection is confirmed
β†’ Not required for most viral coughs

⚠️ Avoid routine use of cough suppressants in wet cough, as suppressing cough can trap mucus in the lungs.

🟣 Lifestyle & Supportive Measures

β†’ Avoid smoking and second-hand smoke
β†’ Keep head elevated while sleeping
β†’ Perform gentle chest physiotherapy if advised
β†’ Maintain good hydration throughout the day

🟣 When to See a Doctor

β†’ Wet cough lasting more than 2–3 weeks
β†’ Fever, chest pain, or breathlessness
β†’ Green, yellow, foul-smelling, or blood-stained sputum
β†’ Elderly, children, or patients with lung disease

⭐ Key Takeaway

β†’ Wet cough helps clear the lungsβ€”do not suppress it unnecessarily
β†’ Treatment focuses on loosening mucus and treating the cause
β†’ Persistent or severe symptoms always need medical evaluation

A clear understanding of CCU, ICU, and HDU matters in clinical practice.These units serve different levels of patient ca...
01/01/2026

A clear understanding of CCU, ICU, and HDU matters in clinical practice.

These units serve different levels of patient care inside a hospital. Here is a professional overview.

β€’ ICU
-Intensive Care Unit.
-Designed for critically ill patients.
-Provides ventilator support and advanced life support.
-Ensures continuous 24-hour monitoring.
-Used for multi-organ failure and life-threatening conditions.

β€’ CCU
-Coronary Care Unit.
-A specialized form of critical care.
-Dedicated to cardiac patients.
-Manages myocardial infarction, severe arrhythmia, and acute heart failure.
-Includes continuous ECG and cardiac monitoring.

β€’ HDU
-High Dependency Unit.
-For patients who require close observation but -do not require full ICU support.
-Common after major surgery or step down from the ICU.
-Offers higher monitoring than general wards.

Key takeaway.
ICU handles the highest level of critical illness.
CCU focuses on cardiac critical care.
HDU bridges ICU and general ward care.

Clinical clarity leads to better decisions.
Sharing knowledge through The Pharma Diaries.

Dr. Justine Kiplagat
WhatsApp 0704 574610
Email justinekiplagatkiprop@gmail.com

As we close the year 2025, I just want to say thank you. Thank you for the love, support, laughter, and even the lessons...
31/12/2025

As we close the year 2025, I just want to say thank you. Thank you for the love, support, laughter, and even the lessons we shared along the way. This year had its ups and downs, but knowing I had you all beside me made every moment more meaningful.

I’m grateful for the memories we created, the time we spent together, and the bond we continue to grow. As we step into a new year, I hope it brings us good health, peace, happiness, and many more moments to celebrate together.

Wishing you all a joyful celebrations as you asher in a bright, beautiful year 2026. β€οΈπŸŽ‰πŸŽ‰πŸŽ‰

Master Mechanical Ventilation
09/09/2025

Master Mechanical Ventilation

The cardiovascular system is responsible for delivering oxygen and nutrients to tissues while removing waste products.It...
28/08/2025

The cardiovascular system is responsible for delivering oxygen and nutrients to tissues while removing waste products.

It includes the heart, blood vessels, and blood, and works closely with the respiratory system to maintain homeostasis.

For respiratory therapists...

Understanding cardiovascular function is essential because heart and lung function are deeply interconnected.

Problems in one often affect the other!

Here are some important tips to remember:

Know the flow of blood: Understand the path of blood through the heartβ€”from the vena cava to the right atrium, through the lungs, and out the left ventricle to the body. This helps interpret hemodynamic data and heart-lung interactions.
Understand cardiac output: It's calculated as stroke volume Γ— heart rate. A drop in either one can lead to inadequate tissue perfusion. Watch for changes in these values in critically ill patients.
Recognize signs of poor perfusion: Low blood pressure, cool extremities, cyanosis, decreased urine output, and altered mental status can indicate reduced cardiac output or shock.
Interpret key pressures: Central venous pressure (CVP) reflects right heart preload. Pulmonary artery pressure (PAP) and pulmonary capillary wedge pressure (PCWP) reflect left heart function and can help diagnose conditions like CHF or pulmonary hypertension.
Oxygen delivery depends on both systems: Even if the lungs are working fine, poor cardiac output means tissues may still be hypoxic

Had a privilege to share knowledge with my colleagues about BLS ACLS
28/08/2025

Had a privilege to share knowledge with my colleagues about BLS ACLS

24/08/2025

Get to understand the levels of care in an hospital set up. From the Ward, HDU to ICU. Thank you Emilie Ashihundu - Aga khan university Hospital ICU Manager.

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