Nursing Care for End-StageRenal Disease by General Anesthesia for Renal Transplantation

Abstract

Renal transplantation is one of the best choices for renal replacement therapy in end-stage renal disease (ESRD) patients leading to a better survival rate and quality of life.

Nursing care during general anesthesia for renal transplantation surgery becomes complicated due to patients’ physiologic change in mu;tiple organ systems (for example hypertension, anemia) which cause them to suffer from cardiovascular complications. A nurse anesthetist, who plays an important role in patient care, should not only do preanesthetic visit consisting of preanesthetic evaluation and preparation for patient’s readiness for surgery physiologically and psychologically but also evaluate patients’ health risks and plan together with other anesthesiologists for perioperative care including anesthetic drugs administration, monitoring, and postoperative pain management. To accomplish all of the tasks, a nurse anesthetist should have both knowledge and skills to ensure that patients will be safe and return to their normal life. Accordingly, this case study investigated renal transplantation surgery in an end-stage renal disease patient.

Result : A 23-year-old Thai male patient suffering 3 year of end-stage renal disease was planned for renal  transplantation surgery under general anesthesia. Intraoperatively, the patient’s conditions including vital signs and organ functions remained stable without any complication. At immediate postoperative time, the urine output indicated the recovery of renal function. Although the patient experienced some pain and hypertention, all of these symptoms could be controlled successfully. Before discharged, he was provided with health education about personal hygiene, eating habit, and appropriate exercise to promote physical strength and to prevent infection. He was prescribed immunosuppressants and came to the hospital for follow-ups. The total length of his hospital stay was 16 days.

In summary, this case study can be used as a  guideline for perioperative care in ESRD patients undergoing renal transplantation.