Hemodialysis

Hemodialysis

During renal failure, the kidneys are unable to perform their life maintaining functions. Waste products and fluids build up (uremia), leaving the patient feeling nauseated, itching, short of breath, fatigued. The patient may also experience edema, loss of appetite, feel irritable, or have trouble thinking clearly. It may also be possible the kidneys may stop working so slowly that the patient won’t notice any of these symptoms. The degree of renal failure can be measured by blood and urine tests (BUN and creatinine levels). Some patients may be monitored for long periods of time before they reach End-Stage-Renal-Disease. ESRD may be caused by uncontrolled diabetes, high blood pressure, glomerulonephritis, arteriosclerois, obstructions to the urinary system, toxins, trauma, or infection. One of the most common treatments for ESRD is hemodialysis. This uses a kidney dialysis machine to filter waste products and excess fluids from the blood. During hemodialysis the blood flows from the body through and intravenous access such as a shunt or fistula, to a dialysis machine, where it passes through a dialyzer (filter). The clean blood is then returned through the access. This process generally takes two to four hours depending on the doctor’s order for each patient. Most patients have treatments 3 times per week. Registered nurses direct the care available in freestanding or hospital-based dialysis units. They provide individualized care to the renal patients and ensure that dialysis equipment is working properly. The dialysis team may also include technicians who manage machine operation. In general, the basic duties of a dialysis nurse are to consult with doctors regarding a patient's overall treatment plan and to alert doctors to any changes in a patient's condition. Since dialysis purifies the blood of toxins and balances body fluid make-up, dialysis nurses must interpret blood lab values, which reflect the impact of treatment. The treatment goal is to bring each patient's blood values as close to normal as possible. Kidney failure affects many other body processes including cardiovascular, pulmonary and gastrointestinal systems. Dialysis nurses must be aware of the signs of kidney failure and must evaluate their patients regularly to make sure treatments are effective. Dialysis nurses develop a close relationship with patients and their families, as dialysis treatment is typically required three days a week. In addition, patients must be actively involved in their health management particularly nutrition and exercise to maximize the benefits. Providing clear patient education with motivational encouragement is a major component of the dialysis nurse role. This education also involves information about the primary disease initiating the kidney failure. For most dialysis patients, this underlying cause is either diabetes or hypertension. Patients with chronic renal failure can become disheartened and discouraged about their condition. Dialysis nurses use strong communication and leadership skills combined with a positive outlook to assist and motivate their patients.