文档介绍：L o g o Instructor: Participants : Nursing Round1 Main content 1. General information on patient 1. 1. General information on patient General information on patient 2. History and present illness 2. 2. History and History and present illness present illness 3 . Laboratory tests 3 3 . . Laboratory tests Laboratory tests 4 . Care issues and measures 4 4 . . Care issues and measures Care issues and measures 5. Health e ducation 5. 5. Health Health e e ducation ducation General information General information ? Name: 吴** Gender:female ? Age:48y ? Start dialysis:2009-8-3 ? Dialysis frequency: 5 times/ 2 week ? Vascular access for hemodialysis: AVF ? Diagnosis:CGN( 慢性肾小球肾炎) History History illness illness History and History and present illness present illness Present illness Present illness Deep venous Deep venous catheter catheter surgery surgery (深(深静脉置管手术静脉置管手术史); 史); Hepatitis B Hepatitis B ; ; Repeated Repeated nausea and nausea and vomiting vomiting , , o o liguria liguria ( (少尿少尿) ). . Present illness Present illness ?患者现呈灰暗面貌,自透析以来,尿量逐渐减少,至今年 10 月份无尿。患者收缩压波动在 140-190mmg ,舒张压在 70-100mmg ,双下肢凹陷性浮肿明显,伴瘙痒。透析过程中常出现恶心呕吐,肌肉痉挛,曾急发左心衰。现口服降压药压氏达,抗贫血药力蜚能,纠酸药小苏打,每周一次 Ep i ao 。家庭经济状况不好。? The patient has a gloomy the dialysis,the urine is on the decline,untill October this year the urine is SBP of the patient ranges from 140 to 190mm Hg ,the DBP of the patient ranges from 70 to 100mm H g. The edema of the legs is obvious,along with the pruritus (瘙痒) .The nausea and vomiti nausea and vomiti ng ng happens happens frequently,the frequently,the left heart failure left heart failure happened twice. happened twice. ?压陷性水肿 Laboratory tests Laboratory tests Normal value 2010-12 2011-03 BUN before the dialysis 21-28 42 BUN after the dialysis 1/3(21-28) ALB(g/L) >35 HCT(l/L) - K(mmol/L) - Hb(g/L) >110 40 36 Fe(mmol/L) -30 P