尿毒症英文护理查房1PPT课件.ppt

L o g o Instructor: Participants： Nursing Round1 Main content 1. General information on patient 2.History and present illness 3. Laboratory tests 4. Care issues and measures 5. Health education General information Name:吴** Gender:female Age:48y Start dialysis:2009-8-3 Dialysis frequency:5 times/2 week Vascular access for hemodialysis: AVF Diagnosis:CGN(慢性肾小球肾炎) History illness History and present illness Present illness Deep venous catheter surgery（深静脉置管手术史）； Hepatitis B； Repeated nausea and vomiting，oliguria(少尿). Laboratory tests Normal value 2010-12 2011-03 BUN before the dialysis 21-28 49.87 42 BUN after the dialysis 1/3(21-28) 15.7 16.8 ALB(g/L) 35 35.1 30.3 HCT(l/L) 0.37-0.48 0.13 0.11 K(mmol/L) 3.5-5.5 4.77 5.46 Hb(g/L) 110 40 36 Fe(mmol/L) 9.0-30 48.5 3.81 PTH(pg/mL) 150-300 632.6 1120 P(mmol/L) 0.96-1.78 2.41 2.10 Cr(mmol/L) 62-115 1179 1101 Blood β2micro blobulin 0-2.2 44.22 38.10 Nursing problem 营养失调 骨痛，瘙痒 体液过多 Related to excessive intake and dehydration(脱水) shortage. Below the body‘s requirements. Related to inadequate intake of Fe 、 protein and EPO , it lead to anemia（贫血）. Related to the high phosphorus and PTH ,it lead to the Renal bone disease. Fluid overload malnutrition Bone pain,pruritus Psychological care（心理护理） Nursing problem High blood pressure(高血压) Muscle spasms （肌肉痉挛） nausea and vomiting (恶心呕吐) High potassium hematic disease (高钾血症) Acute left heart failure（急性左心衰） Complications (并发症) 1. Fluid overload 严格限制水钠入量，透析间体重增长小于5%干体重。 Strictly limit the amount of water ，the growth of the weight is less than 5% of dry weight. 增加透析次数，可改为每周两次HD，一次HDF，每次脱水量为透前体重减去干体重加300ml()。 increase the times of dialysis,it may be 2 hemodialysises and 1 hemodiafiltration every week. Tips Use the cup which has scale; Eat something sour when feels thirsty. Use the cold water to gargle. Guide the patient to weigh seriou