patient modifications

[momandstudent]

I just did an observation in our local hemodialysis unit. Just to let you know-you guys rock!!! It was such an inspiring environment after being in the LTC and Med-Surg unit. I loved every bit of it. Especially the relationship between the nurse(s) and patient(s). I have to answer a few questions about my experience but I am having trouble with one of them. It is: What do patients need to modify after starting on chronic dialysis? I know they need to modify their diet by watching their fluid and caloric intake and they also have to have a low-potassium diet. What else am I missing? I have researched my textbooks (of course you can't find any info regarding educating the patient in them) and the internet. I just don't know what else needs to done. Thank you for any input.

[Daytonite, BSN, RN]

Basically, you are being asked to give the manifestations of the pathophysiological changes of renal failure with a nursing care twist. Approach this logically using the nursing process. First, think about ADLs. What things do we all do everyday? When I first started nursing school 30+ years ago we were given a list of 10 things we do everyday. I was shocked at the time that my day could be made into a list of ten things, but there it was. This is Roper, Logan & Tierney's 12 Activities of Living:

• Maintaining a Safe Environment
  
• Communicating
  
• Breathing
  
• Eating and Drinking
  
• Eliminating
  
• Personal Cleansing and Dressing
  
• Controlling Body Temperature
  
• Mobilizing
  
• Working and Playing
  
• Expressing Sexuality
  
• Sleeping
  
• Dying

I worked on a renal unit. Every single one of the above is altered by renal disease. Being on dialysis puts a bigger restriction on a person's ADLs. In talking with CRF patients I was always saddened to find how dramatically the RF had changed their life. It explained why so many rushed to have a transplant when it was a possibility.