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Nursing Care Plan for Diabetics on Maintenance Dialysis

2012-09-27 16:07

Diabetic Nephropathy is a severe complication of Diabetes. In end-stage kidney disease, the kidneys fail to filter wastes effectively so Diabetics need to start dialysis to maintain their life. The dialysis machine removes toxins from the body so that it will make the patients feel better. For people with Diabetes, daily care nursing is an essential part of the treatments which will improve quality of life and reduce complications. The patients themselves as well as their family members need to manage the condition well so they need to learn what their daily nursing plain includes and what the targets are.

The nursing care plan for people with Diabetics on maintenance dialysis includes the following aspects:

1. Management of high blood pressure

Healthy kidneys help to regulate blood pressure. Diseased kidneys will cause high blood pressure. Insufficiency in removing excessive water during dialysis will increase BP level. For people on maintenance dialysis, high blood pressure can worsen kidney condition and increase risks of heart disease and other vial complications. Monitoring blood pressure before, during and after dialysis is recommended; those on anti-hypertensive medicines are suggested to test BP for several more times during dialysis to evaluate if BP is controlled well.

2. Management of blood glucose

Fluctuating blood glucose is an independent risk factor for diabetics on dialysis. Presence of hypoglycemia will cause such symptoms as headache, sweating, hunger, irritation, barylalia, etc. Observe if the patient has any sign of hypoglycemia during dialysis. Prepare one or several candies for emergency use. Management of blood glucose helps to reduce risks of diabetic complications.

3. Protein supplement

After dialysis, the patient will have a better appetite because the wastes are removed out of the body. About 2 to 3.5g protein is lost during dialysis. After dialysis, daily protein supplement for 1-1.2g/kg is suggested to improve nutrition status. Egg white, milk, lean meat and other high quality animal proteins are priorities.

4. Iron supplement

Supplement sufficient irons and vitamin C content vegetables to make up for the loss during dialysis. This assists in medicine prescription to improve anemia state.

5. Close observations

Observe urine output and color changes. Do urinalysis and urine gravity test for at least once a week.

6. Keep track of the intake of water and sodium

Keep a record of 24h urine output and the intake of sodium and fluid. Generally, it is suggested that daily fluid intake should be 500ml+ the urine output the day before.

For Diabetics on maintenance dialysis, regular check-ups and communication with doctors are essential to evaluate whether the illness condition is well controlled and any risks. Learn as much as possible to be clear of essential care measures and alert of any signs of complications. For anything unclear, you may leave us a message, and we will email back soon for free.


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