Nursing measures of uremia patients with chronic renal failure

Nursing care of patients with chronic renal failure: Correct nursing care can effectively delay the process of renal damage in patients with chronic renal failure, while improper nursing care may lead to rapid deterioration of renal function in patients with chronic renal failure and enter uremia. How to care for patients with chronic renal failure? Here, let's talk about the care of patients with chronic renal failure. What aspects should be paid attention to in nursing patients with chronic renal failure? Nursing care of patients with chronic renal failure mainly includes the following points: 1. Provide appropriate nutritional support.

1, reduce the intake of protein in food. When the patient's urine is low or blood urea nitrogen (BUN) is higher than 80 mg%, dialysis should only be done once a week, and the protein should be limited to 20-25 grams per day. If dialysis is done twice a week, it should be limited to about 40 grams. If you receive dialysis three times a week, protein doesn't have to limit it.

2, should take enough calories, 2 500 calories a day, sugar should be more than150g a day, to prevent protein damage in the body, slow down the increase of blood nitrogen, and enhance immunity. Nursing points of patients with chronic renal failure II. Observe and assist in dealing with electrolyte imbalance in body fluids.

1, record the intake (drinking water and infusion) and output (including urine, diarrhea, vomiting, nasogastric tube drainage, gains and losses of peritoneal dialysis water, etc. ) within 24 hours.

2. Weigh yourself every day. Wear clothes with the same weight at the same time every day if conditions permit, and measure your weight with the same weighing scale after emptying your bladder. If the weight changes, it can be considered that it is related to excessive water intake. It is necessary to adjust the water intake and keep the balance between intake and outflow.

3. Limit the input of liquid. Glomerular filtration rate decreased and urine volume decreased. In order to prevent the retention of water and sodium, the amount of water and sodium should be limited. It is difficult for patients to limit the input of liquid and salt. Be careful not to put water tanks and fruits beside the bed, so as not to make patients feel more thirsty. Let patients control themselves and understand the importance of limiting liquid salt.

4, pay attention to the reaction of ion exchange resin, peritoneal dialysis, hemodialysis and other applications. Symptoms such as confusion, muscle weakness, numbness, nausea, diarrhea and abdominal pain, bradycardia, etc. We should be alert to the occurrence of hyperkalemia.

5. It helps to improve the imbalance of low calcium and high phosphorus in the blood and reduce the harm to the body. Observe the symptoms of bone pain, assist in total joint exercise, and give patients aluminum hydroxide, calcium tablets and vitamin D according to the doctor's advice.

6. Help maintain acid-base balance in the body. Usually observe the patient's breathing frequency, rhythm, depth (whether there is rapid and deep paroxysmal breathing), mental state, drowsiness, headache, forgetfulness and so on; Disorientation, insanity, etc. Nursing points of patients with chronic renal failure. Improve comfort and promote rest and sleep.

2. Cardiovascular system:

(1) Observe closely whether antihypertensive drugs and diuretics have any side effects.

(2) Closely monitor the change of blood pressure: We should measure the blood pressure in different positions, including lying position, sitting position and standing position, to know whether there is postural hypotension.

(3) Control the intake of salt and water: the daily intake of salt is 5g, the intake of liquid depends on the urine volume, and it is appropriate to add 500-800ml to the urine volume.

(4) Patients with headache and high blood pressure should stay in bed and don't get out of bed to prevent accidents.

1, digestive system

(1) Keep your mouth clean and moist to prevent ulcers or infections.

(2) Reduce nausea and vomiting. Let patients eat more meals in small quantities, and take normal saline 1 ~ 2 times before going to bed at night to avoid dehydration at night, so that blood urea nitrogen will increase relatively, and nausea and vomiting will occur after waking up in the morning, which can stimulate the appetite for hard candy;

(3) Observe the color of vomit and feces, and notify the doctor immediately if bleeding is found; .

(4) Strengthen activities to prevent constipation.

4. Nervous system:

(1) Urotoxin has certain effects on nervous system. Always talk to patients, discuss immediate problems, confirm patients' reactions, and assist doctors in evaluating patients' consciousness and mental state.

(2) For patients with headache, insomnia and irritability, attention should be paid to not having too strong indoor light and keeping quiet.

3. Hematopoietic system

(1) Observe the anemia of patients, and see if the skin, lips, nails, sublingual mucosa, oral mucosa and conjunctiva are pale and weak, prone to fatigue, tachycardia and shortness of breath.

(2) For patients with blood transfusion, observe the emergence of blood transfusion reaction.

(3) Hemodialysis patients are given water-soluble vitamins and folic acid due to the loss of vitamins in their bodies.

(4) For patients with shortness of breath, rest more, give oxygen to people, and insert a nasal catheter for patients, so that patients can really breathe oxygen.

(5) Pay attention to any bleeding site and bleeding situation.

6. Strengthen skin care.

(1) The patient's skin is pale, dull and grayish yellow, and urea cream is deposited on the dry skin, which often causes severe itching.

(2) Female patients should always clean the perineum and keep it dry locally to avoid pudendal itching;

(3) For patients who stay in bed for a long time, help them turn over and prevent bedsores from occurring due to local continuous compression.

(4) Instruct patients to wear loose and soft cotton clothes.

5. Respiratory system: observing whether the patient has symptoms such as cough and chest tightness can prompt upper respiratory tract infection or severe azotemia; If deep breathing accompanied by drowsiness indicates metabolic acidosis, you should contact your doctor for necessary treatment in time. Nursing points of patients with chronic renal failure. Pay attention to prevent complications.

Prevent (1) infection. Patients with chronic renal insufficiency are prone to secondary infection due to low immunity. Respiratory and urinary tract infections are more common, followed by skin and digestive tract infections. Because of the poor response of patients, there is often no high fever after infection. The existence of infection can aggravate the condition and is often the cause of death. Therefore, we should pay attention to keep the room clean, reduce visits, and pay attention to the changes of body temperature, cough, expectoration and defecation. Patients who stay in bed for a long time should be encouraged to take a deep breath to help cough effectively.

(2) prevent the heart from continuing to be damaged. Due to long-term hypertension, arteriosclerosis, anemia, electrolyte disorder and secondary parathyroid hormone increase, myocardial metastasis calcification occurs, which damages the myocardium and is prone to secondary cardiac enlargement, arrhythmia and cardiac insufficiency. Pay attention to reducing the burden on the patient's heart, properly inhale oxygen, closely observe the changes of heart rate and blood pressure, and contact the doctor in time if there are abnormal signs.

(3) Peritoneal dialysis patients should pay attention to prevent abdominal wound infection or peritonitis, while hemodialysis patients should prevent phlebitis. Nursing points of patients with chronic renal failure. Ensure the safety of patients.

1. For patients with blurred vision at the end of uremia, articles should be placed in a fixed position for easy access. Clear obstacles at ordinary times to prevent falling. For patients who completely disappear, they should be assisted in action.

2, if the patient is in a coma, should prevent falling, such as using the bed bar, etc.

3, anemia or long-term bedridden patients, when the bed activity, the action should be slowed down, and beside to help.

Nursing points of patients with chronic renal failure. Assist patients to adapt to dialysis lifestyle and give spiritual support.

1. Patients with renal failure are usually forced to choose treatment methods under fatigue and depression. Whether hemodialysis or peritoneal dialysis, dialysis life is long. Approach patients with warm and caring attitude, learn the related knowledge of hemodialysis and peritoneal dialysis with patients, and assist patients to do peritoneal dialysis well. This kind of support can help patients build confidence in overcoming diseases and living again.

2. The support of family and friends is the most important and desirable for patients.