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Hemodialysis III: Nursing Management

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The nursing management of a patient undergoing hemodialysis includes several critical steps, starting with a thorough assessment before the procedure.Before the Hemodialysis ProcedureFirst, record the patient's vital signs—blood pressure, heart rate, respiratory rate, and temperature—to establish a baseline. This baseline is essential for detecting conditions such as hypotension that could impact the patient's response to dialysis. Document the patient's pre-dialysis weight, as this...
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Water balance disorders are medical conditions that occur when there is a deviation from the body's water volume or osmolarity, disrupting normal homeostasis and leading todehydration, hypotonic hydration, hyperhydration, edema, or water intoxication.
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Causes:
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The force applied by fluids against a surface, known as hydrostatic pressure, initiates the transfer of fluid among different compartments. Within our blood vessels, the blood's hydrostatic pressure is a result of the heart's pumping action. At the arteriolar end of capillaries, hydrostatic pressure (capillary blood pressure) exceeds the opposing colloid osmotic pressure created primarily by plasma proteins like albumin. This discrepancy in pressure propels plasma and nutrients from the...
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Symbiotic relationships are long-term, close interactions between individuals of different species that affect the distribution and abundance of those species. When a relationship is beneficial to both species, this is called mutualism. When the relationship is beneficial to one species but neither beneficial nor harmful to the other species, this is called commensalism. When one organism is harmed to benefit another, the relationship is known as parasitism. These types of relationships often...
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Related Experiment Video

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In Vitro Assay of Plasmodium-Infected Red Blood Cell Killing by Cytotoxic Lymphocytes
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Malaria and fluids--balancing acts.

Tim Planche1

  • 1Department of Cellular and Molecular Medicine, Infectious Diseases, St George's Hospital Medical School, London, UK, SW17 0RE. tim@planche.demon.co.uk

Trends in Parasitology
|October 21, 2005
PubMed
Summary

Severe malaria, characterized by coma and lactic acidosis, often leads to rapid death. Dichloroacetate offers a potential adjunctive therapy to safely treat lactic acidosis and improve survival rates in severe malaria patients.

Area of Science:

  • Infectious Diseases
  • Tropical Medicine
  • Biochemistry

Background:

  • Severe malaria presents with life-threatening manifestations like coma and lactic acidosis.
  • Mortality in severe malaria remains high, often occurring within 24 hours of admission, despite antimalarial treatment.
  • Previous adjunctive therapies have failed to improve outcomes, highlighting the need for novel interventions.

Purpose of the Study:

  • To investigate the pathophysiology of lactic acidosis in severe malaria, independent of volume depletion.
  • To evaluate the safety and potential efficacy of dichloroacetate as an adjunctive therapy for severe malaria.

Main Methods:

  • Review of existing literature on severe malaria pathophysiology and adjunctive therapies.
  • Analysis of the role of metabolic acidosis in malaria, distinguishing it from hypovolemia-induced acidosis.

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  • Consideration of dichloroacetate as a treatment for lactic acidosis in malaria.

    • Main Results:

    • Lactic acidosis in severe malaria is likely driven by factors other than volume depletion.
    • Dichloroacetate has demonstrated safety in treating lactic acidosis.
    • No adjunctive therapies have shown benefit in previous trials, with some worsening outcomes.

    Conclusions:

    • Dichloroacetate may serve as a safe and effective adjunctive therapy for severe malaria.
    • Targeting lactic acidosis with dichloroacetate could reduce mortality rates in severe malaria.
    • Further clinical trials are warranted to confirm the efficacy of dichloroacetate in severe malaria.