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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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Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
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Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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A Study Describing Patients' Perspectives on Cognitive Function Screening During Hemodialysis.

Maureen Metzger1, Souad Benloukil2, Zahra Alisa3

  • 1Assistant Professor of Nursing, the University of Virginia School of Nursing, Charlottesville, VA.

Nephrology Nursing Journal : Journal of the American Nephrology Nurses' Association
|July 8, 2022
PubMed
Summary

Cognitive function screening is recommended for end-stage kidney disease (ESKD) patients on hemodialysis but rarely performed. Patients generally find screening acceptable, though those with cognitive impairment rate it less favorably.

Keywords:
Montreal Cognitive Assessment (MoCA)cognitive function screeningfeasibility and acceptabilitypatient perceptionspatients receiving hemodialysis

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Area of Science:

  • Nephrology
  • Geriatrics
  • Neuropsychology

Background:

  • Routine cognitive function screening is recommended for end-stage kidney disease (ESKD) patients.
  • Screening is infrequently implemented in clinical practice for this population.

Purpose of the Study:

  • To identify barriers to cognitive function screening in patients with ESKD undergoing in-center hemodialysis.
  • To assess patient perceptions and acceptability of cognitive screening.

Main Methods:

  • Structured interviews were conducted with 100 patients (aged ≥50 years) at seven hemodialysis centers.
  • Participants completed the Montreal Cognitive Assessment and Geriatric Depression Scale.
  • Patient perceptions of the screening experience were evaluated.

Main Results:

  • Cognitive function screening was rated favorably by participants, indicating general acceptability.
  • The only significant factor associated with screening evaluation scores was the level of cognitive impairment.
  • Patients with mild or moderate cognitive impairment evaluated the screening less favorably than those with normal cognitive function.

Conclusions:

  • Cognitive function screening is acceptable to patients with ESKD on hemodialysis.
  • Patient-reported outcomes suggest that cognitive impairment itself may influence screening perceptions.
  • Further research should address system-level barriers and establish follow-up protocols for abnormal results.