Nursing care for patient with end stage renal disease (ESRD) having peritonitis from continuous ambulatory peritoneal dialysis (CAPD) and changed to hemodialysis

Abstract

A Thai female, 59 year old, having the history of end stage renal disease with hypertension with DM on CAPD for 1 year was checked at Chronic Kidney Disease Clinic on 27 May 2019. From the patient information, the dialysate fluid showed cloudy appearance for 2 day. Therefore, this dialysate fluid was sent to microbial testing. From the microbial testing result, gram negative bacillus was found in dialysate fluid. Furthermore, a patient with Intra-abdominal infections was observed. Thus, surgeon taken off the tenckhoff (TK). A patient was treated by caring for the abdominal wounds and medication with antibiotics and then she was admitted to the medical ward for 3 day. The dialysis of patient was changed from CAPD to hemodialysis, 2 times a week, every Tuesdays and Friday. During the patient in Hemodialysis unit, nurse advised a patient for preparation of hemodialysis, helped the doctor to pierce the double lumen catheter and nursed during and after hemodialysis. During hemodialysis, excess water condition of patients was observed but this condition was corrected until out of danger. A patient was discharged on 19 June 2018. In the present, a patient was regularly treated the dialysis by hemodialysis for 2 time a weeks without complications. A patient can help herself and has a good quality of life.

Hemodialysis nurses are required for highly knowledge and skills in their operations. The evaluation of patient’s readiness, planning of nursing and preparation of instrument for hemodialysis should be ready before hemodialysis. The prevention of complications with occurring and correcting immediately for good patient safety are using nursing process and corporation with health team before and after hemodialysis.