/A new nursing model for the care of patients with chronic kidney disease

A new nursing model for the care of patients with chronic kidney disease

author:admin       pubdate:2017-09-05 14:38

A new nursing model for the care of patients with chronic kidney disease

Chronic glomerulonephritis Patient care:

Chronic glomerulonephritis referred to as chronic nephritis, is a group of disease progression, slow progress in the disease, and ultimately the development of chronic renal failure of primary glomerular disease.

(1) etiology and pathogenesis

Most patients do not know the cause, a small number of patients with acute nephritis history. Most cases of glomerular immune complex deposition. Infection, dehydration, overwork, pregnancy and the application of nephrotoxic drugs are predisposing factors.

(2) clinical manifestations

Sudden onset, but also hidden slowly onset. Clinically, edema, hypertension, proteinuria, hematuria and renal dysfunction as the basic performance. Mild, moderate proteinuria is the performance of hematuria mostly microscopic hematuria, inpidual patients with high blood pressure is its main, very prominent symptoms, renal function damage is the gradual occurrence and development, and its degree, In some cases deteriorated sharply. Due to long course of disease, long-term medication and the treatment effect is not ideal, lack of knowledge of the disease knowledge, so that patients and their families feel anxious and worried about the late emergence of renal failure, the patient often produce depression, fear, pessimism, despair and other negative emotions.

(3) auxiliary inspection

① urine examination, urinary protein often positive, almost all patients have varying degrees of hematuria and tubular urine, urine is low, late often fixed at around 1.010.

② blood tests are mild to moderate to severe anemia.

③ renal function tests, serum creatinine, urea nitrogen increased, GFR decreased.

④ B ultrasound, renal biopsy of the diagnosis of meaningful.

(4) treatment points

① mild symptoms can be light from work, to avoid cold, to prevent infection, do not use drugs harmful to the kidneys. At the same time to low protein, low phosphorus, low salt diet.

② diuretic, obvious swelling of the patient can diuretic swelling. Such as hydrochlorothiazide, furosemide, spironolactone, and the like.

③ antihypertensive, preferred angiotensin converting enzyme inhibitors, but also available diuretics, propranolol, nifedipine, hydralazine and so on.

④ anti-platelet aggregation drugs, long-term use of dipyridamole, aspirin and other anti-platelet drugs, can improve microcirculation, can delay renal function decline.

(5) Nursing measures

① on the body severe edema, elevated blood pressure or organ dysfunction to increase bed rest time, but to prevent venous thrombosis of the lower limbs; attention to psychological care; strengthen the skin, oral care.

② reasonable diet, to maintain water balance.

③ close observation of changes in condition, early detection of early signs of uremia, heart damage and signs of hypertensive encephalopathy.

④ accurate implementation of the doctor prescribed medication, close observation of treatment response.

⑤ on the implementation of renal biopsy, do a good job explaining and preoperative preparation.

⑥ inform the patient and their families to avoid all kinds of incentives, a reasonable diet, work and rest, regular outpatient follow-up after discharge.

(6) health education

① pay attention to the law of life, to avoid fatigue.

② pay attention to personal hygiene, appropriate exercise, improve the body resistance, prevention of infection.

③ avoid alcohol and tobacco.

④ to avoid the application of kidney damage drugs, blood pressure should not be too fast, too low, with persistent renal dysfunction or poor prognosis is poor.

Tag:

Realated article