Using nursing diagnoses to achieve desired outcomes for hemodialysis clients

As part of the multidisciplinary end-stage renal disease (ESRD) health care team, nephrology nurses assess, diagnose, plan, implement, and evaluate nursing care for hemodialysis clients. As the team member with the most consistent contact with the client, registered nurses not only practice within their own unique domain but also refer to medical, nutritional, and social work staff. Use of the taxonomy of nursing diagnosis provides a framework for nurses to identify client problems and risk factors that they can treat independently. The use of client surveys specific to the Health Care Financing Administration (HCFA) core indicators: anemia, low albumin, treatment adequacy, and hypertension, enhances collection of subjective data from patients and increases their participation in care planning. Nursing diagnoses common to clients with these four conditions and related nursing interventions are presented in this article.