Hemodialysis

By using a specialized equipment, hemodialysis removes nitrogenous waste, extra fluid, and electrolytes from the blood.

Indication:

• Fluid overload not responding to diuretics.
• Uremic convulsion
• Persistent dyspnea, vomiting and restlessness
• Signs of pericarditis, pericardial effusion and pericardial friction rub.

Nursing management:

Before dialysis:

• Informed approval.
• Procedure justification.
• As the patient to urinate.
• Weight and vital blood pressure should be checked at the start and at least every 30 minutes.
• Check for canula and fistula patency every hour for the first 24 hours following insertion, and then every 4 hours using a palpator and an auscultator to listen for bruits.
• On the day of the dialysis, avoid taking antihypertensives and antidiuretics.
• Assurance.

During dialysis:

• Routine monitoring of complications.
• Every 15 minutes, check your vital indicators and record them.
• Meal serving advice based on patient interest.
• A patient is permitted to read, write, sleep, speak, or watch television while receiving treatment.
• Back treatment and distraction therapy.
• If there is a problem, tell the doctor.

After dialysis:

• Vital signs, weight after hemodialysis, and total UF should be checked and recorded.
• Keep a patient's condition on file.
• medicines as prescribed.
• Describe the post-HD care that is required.
• Before the next dialysis, inform the patient's family and the patient.
• Send the patient to the ward or home.

Care of anterior venous fistula:

• Prior to and following each treatment, make sure the nurses or DR check the access.
• Keep the entrance tidy at all times.
• Do not allow someone to cuff your arm with a blood pressure monitor.
• Don't accessorize with jewelry or tight clothing.
• Avoid sleeping with your arm under your head or body.
• Don't exert pressure on the arm or lift large objects.
• Every day, check the pulses on your access.

Health education for patient under HD:

• Maintaining vascular access.
• Detection of a problem.
• Discuss the cost implications of the treatment.
• Tell the patient to diet.
• To consume animal proteins like meat and poultry.
• A diet high in potassium should be avoided as it may be bad for the heart.
• Must consume less fluids because this can lead to cardiac problems and excessive blood pressure.
• To avoid using too much salt.
• Phosphorous-containing foods such milk, cheese, nuts, etc., should be kept to a minimum.

References

• Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013