The nursing care of patient with Diabetes Mellitus and End Stage of Renal Disease by continuous ambulatory peritoneal dialysis (CAPD)

Abstract

A 44 years old Thai female known case 10 years of Diabetes Mellitus. She had uncontrolled  blood sugar level and chronic kidney disease for 3 years. She was treated from Srabhoth hospital  continuously to Banmi hospital, followed up At the CKD clinic, out patient department, the nurses provided nursing process in 3 phases of nursing care for her, pre assessment, intra examination and post examination in order to make her a fast and properly services. Nursing assessment started with screening, took history of illness, physical examination, preparation for laboratory investigation, evaluation of health pattern, and took of vital signs. At first examination, she had mild fatigue, edema and nausea. The doctor gave her a diagnosed of DM with End stage renal disease. Laboratory investigation found hyperkalemia, so the nurse took rapid response for the stat dose of medicine and closed observe.  Nurses found both patient and family had anxiety because the loss of the knowledge of the procedure of Insertion Tenckhoff’s catheter for continuous ambulatory peritoneal dialysis (CAPD) and how to manage their lifestyles. Patient and family should be offered information and education on a healthy lifestyle, safety and proper environment. To collaborate with interdisciplinary team and consulted the dietitian for appropriate diet, amount of nutrition, applied of menu that sufficient of protein, limited of salt, high fiber diet, and laxative to help bowel movement. Post examination patient was improved less fatigue and was referred to ward for pre operation nursing care for Insertion Tenckhoff’s catheter for continuous ambulatory peritoneal dialysis (CAPD). Intra operation there was no complication and Post operation, she was discharged completely, length of stay 4 days. The patient had followed up at the out patient department, nurses referred her to the home visited the team and the nurses at the Srabhoth village hospital for continuous care especially for home and family evaluation also the follow up program every month. The conclusion for this patient was, she received continuous care and her family played a role of care together with nurses. The patient could adapt her life style they had the nurses call number to consult of health problem and every followed up period the doctor repeated  knowledge and practice followed the result of blood examination.

This study suggests that The most important nursing care for patients who had Diabetes Mellitus with end stage renal disease was the nursing team who had the knowledge, skill also service mind , attention to empowerment patient and family with the continuous treatment by the interdisciplinary team. And confirmed the holistic care for them.