According to the National Institute of Diabetes and Digestive and Kidney Diseases, more than 661,000 Americans have kidney failure. Of these, 468,000 are undergoing dialysis.
Kidney failure is the end stage of chronic kidney disease, where the kidneys are unable to make urine and remove toxic wastes from the body. The body cannot survive this way so patients need to undergo dialysis, a way to filter waste products and remove excess water from the body. The most common way to perform dialysis is with a dialysis machine that directly filters a patient’s blood. This is called hemodialysis.
Dialysis for kidney failure as a result of chronic kidney disease is a lifelong treatment. So, if you are a caregiver with a patient undergoing regular dialysis, this article is for you!
Here are some important points to remember:
1. Help your patient prepare for their appointments.
Patients need to follow a strict schedule for their dialysis sessions. Whether they receive the procedure in a clinic or at home, they must strictly adhere to the doctor's orders.
For those undergoing dialysis in a center, help them put on a fresh change of clothes. Bring their health records if required. Make sure to arrive at the scheduled time.
2. Be alert for signs and symptoms related to dialysis and kidney failure.
Patients may complain of muscle cramps, itching, problems sleeping, tiredness, and depression. They may also report shortness of breath, a general unwell feeling, nausea, and vomiting, which are all related to low blood pressure. Be sure to tell your supervisor about these effects and make a note of your observations and patient's complaints.
3. Help the patient take their medications as prescribed.
Patients undergoing dialysis need certain medications, so make sure they take them on time, every time.
4. Protect the access site.
Patients in long-term hemodialysis treatment will have a surgically prepared site called a fistula. A fistula is under the skin, so there is no visible catheter or tube. The site is usually on their arm and you’ll notice a vein in that arm is larger than normal. When you gently place your hand over the fistula, you'll feel a slight vibration meaning blood is flowing fast and heavily in that area.
You must protect this site from being bumped, accidentally used to draw blood during procedures, and inflating blood pressure cuffs. If a patient complains of numbness, tingling, or coldness in the area of the access site, hands, and fingers, report it to the nurse or physician right away.
5. Follow the recommended dietary changes.
A patient undergoing regular, long-term dialysis will have food and fluid restrictions. They will need to limit salt, potassium, and phosphorus intake. The patient's dietitian will also have a list of foods to avoid. Since they have excess fluid in their bodies, they also must cut back on fluids. Help your patient follow the doctor’s orders—it can be life-threatening for them if they don't.
6. Have patience.
If you accompany your patient to the clinic, expect that they will need to stay for several hours. Depending on your patient's preference, they may want to sleep during the procedure or keep themselves occupied. Have their books or gadgets within easy reach. You need to stay in designated areas, so practice your patience for waiting.
Caring for a patient on dialysis is not always easy but is often predictable. A caregiver’s role is to support patients during each session and make sure they follow all instructions in the care plan.
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