Nursing care of patients with end-stage renal disease that receive outpatient care: Two case comparative studies

Abstract

The end-stage renal disease (ESRD) with hemodialysis was causes loss of protein and energy, low immunity, infected more easily. The nurse must assess a patient by a holistic approach when they receiving a treatment at the outpatient setting and precaution to life-threatening complications to provide patients with correct treatment and nursing care.

Objective: The purpose to study the outcome of Nursing care of patients with end-stage renal disease that receive outpatient care by comparing two case studies.

Methods: The methods were selecting case studies from the patients with end-stage renal disease that receive outpatient care who were admitted for treatment in In-patient department, Sam Sung Hospital. The data were collected between February to September 2023. The were collected from medical records, patients, and relatives by functional health pattern of Gordon. The data were analyzed followed by the concept of nursing process, using health belief model for plan discharge followed DMETHOD concepts.

Result: Both patients are elderly women. They were end-stage renal disease and undergoing hemodialysis, and admitted to the outpatient setting. First case came with symptoms of high fever, shortness of breath, and unable to lie down, crepitation both lungs, BP 156/78 mmHg, make sure the patient sits and rests, give paracetamol, tepid sponge, nebulized of berodual 1 vial x III, by 15 minutes apart, continuous care for patients at the inpatient ward, found patient problem with pneumonia. The second case came with symptoms of high fever, diarrhea, moderate tenderness for palpation to the abdomen, BP 170/90 mmHg, make sure the patient sits and rests, continuous care for patients at the inpatient ward, found patient problem with gastrointestinal infection. Both cases found problems with waste products retention, and high blood pressure. They received treatment and nurses gradually improved, discharged, and two days for length of stay. They received advice with DMETHOD principles before discharge, and when home visit found that the patients were able to health care correctly.  

Conclusion:  The patients with end-stage renal disease must be evaluated and screened at the outpatient setting and receive nursing care according to the problem before seeing a doctor, forward complete patient information to the inpatient ward, follow up on the patient's condition while admitted in the inpatient ward, promote the patient to health care before discharge by giving advice so that patients can follow it when they come back home, and there is an evaluation by home visiting as well as promoting and encouraging the patient to health care with them self.