Nursing care of dengue fever patients with acute kidney injury treated with renal replacement therapyhttps: Case study

Abstract

Intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT) are renal replacement therapy for elimination of excess fluid, uremic waste and toxic substances from the kidney excretion and the fixing electrolyte imbalance.

In cast study, Thai man, 35 year old, with symptoms of fever, wheezing and diarrhea for 10 times, for 1 day ago was admitted in King Narai Hospital on 25 March 2019. Blood test results presented anemia and thrombocytopenia. Furthermore, ecchymosis in the body of patient was observed. The doctor diagnosed that the patient had a dengue fever.

Thus the patient was received peripheral vein Infusion phlebitis and antibiotic drug. The patient had the excess fluid, acute kidney injury and electrolyte imbalance and then the patient was inserted endotracheal tube. After that, the patient was receiving the IHD for 1 times by the suggestion from the nephrologist. From the evaluation during hemodialysis treatment, the patient had unstable vital signs, low potassium and acidic blood. The hemodialysis treatment of the patient was changed from IHD to CRRT. Hemodialysis nurse provided the nursing care with mind and body assessment, instrument preparation, connecting the cycle of hemodialysis with standard precaution, monitoring of low blood pressure and the levels of electrolyte in the blood and preventing the infection from the hemodialysis. After that the patient's condition has improved and the patient has constant vital signs. The totally, the patient received the CRRT for 3 days. And then the patient was changed from CRRT to IHD for 4 times and the ventilator was removed. The patient was removed to Medical ward. Finally, the patient was discharged on 12 April 2019. Totally, the patient was admitted in the hospital for 19 days.

Hemodialysis nurse is the important person who takes care the patient with treatment by CRRT for 24 h and working together with the nurse in Intensive care unit. For the safety of patient and achievement of hemodialysis purpose, the hemodialysis nurse is necessary person who has the knowledge concerning the evaluation before permanent loss of kidney function, nursing care, surveillance and correction of complications for both patients and the hemodialysis cycle.