A patient is being followed at the dialysis center. He comes in 3 days a week to receive hemodialysis.
Upon entry today for dialysis the patient's VS are T-98.8(o), P-98, R-22, B/P 136/82 and O2sat 94%. His electrolytes are elevated, he feels tried and complains that his legs hurt.
The nurse does a physical assessment and finds LOC alert & orientated X3, Neuro checks are stable and within normal limits. Lungs sounds are crackles bilaterally anterior and posterior. Heart Sounds Normal S1 and S2 sounds at the PMI. Abdomen is round firm and non-distended, BS are active x 4. Pulses are strong peripherally in the upper and weaker in lower. Nurse notes 2+ edema in both legs and the client says it is 5 out 10 for pain.
Actions
2.
3.
DX
1.
5.
Teaching
4.
1. Monitor fluid intake
2. Recheck Vital signs
3. Assess for infection
4. Monitor dietary intake
5. Monitor Blood sugar
1. Renal Failure
2. Dehydration
3. UTI Infection
4. Diabetes Type 2
5. Chronic Heart Failure (CHF)
1. Should avoid canned soups, cold cut sandwiches, and Chinese take-out
2. Walk around the block 2 times per day
3. Watch the intake of water and liquids
4. Eat more Ginger and Bay leaves.
5. Stay in bed until he feels better
