血液透析个案护理课件.pptVIP

人工透析患者的个案护理XX学校XXXXXXAcaseofcarefordialysispatientsHubeiMedicalUniversityFirstly：Patientdata(患者资料）XXX，XX岁，XXX入院，XXX开始透析，透析频率：X次/周。主诉：反复乏力、胸闷X月有余，尿少X月，腹泻X天。XXX,XXyearsold,XXXadmission,XXXdialysis,dialysisfrequency:Xtimes/week.ChiefComplaint:repeatedfatigue,chesttightness,morethanXmonths.OliguriaforXmonth,diarrheaXdays.X余前无明显诱因出现乏力、胸闷，无气促、心悸、胸痛，无发热恶心呕吐，无头晕、头痛。在当地医院诊断为“尿毒症”，予尿毒清服药治疗。症状无改善。X个月前上述症状加重伴尿量逐渐减少，双下肢水肿及腹胀、尿量小于100ml/d，水肿逐渐加重伴气促。10天前明显诱引下出现腹泻，每日解黄色水样便X次，伴上腹隐痛，无恶心、呕吐、无发热、未治疗。今年X来我院就诊。Historyofpresentillness(现病史):Xmorethanamonthago,noobviousincentivetoappearweak,chesttightness,shortnessofbreath,palpitations,chestpain,nofever,nausea,vomiting,dizziness,headache.Diagnosedasuremiaatalocalhospital,ForNiaoduqingmedication.Noimprovementofsymptoms.X,theabovesymptomswithurinegraduallyreduced,lowerextremityedemaandabdominaldistension,urineoutputlessthan100ml/d,theedemagraduallyincreasedwithshortnessofbreath.Diarrhea10daysbeforetheobviousluresolutionyellowwaterystoolsXtimes,withabdominalpain,nonausea,vomiting,nofever,notreatment.Xthisyear,ourhospital.Pastmedicalhistory(既往史)：X余岁患急性肾炎，予青霉素治疗后缓解，今年X日在我院急诊行腹腔穿刺引流术。无高血压、无糖尿病、无风湿性心脏病史、无过敏史、无中毒史。MorethanXyear-oldsufferingfromacutenephritis,topenicillintreatment,mitigation,andonXthisyearinhospitalemergencyabdominalparacentesisdrainage.Nohypertension,nodiabetes,nohistoryofrheumaticheartdisease,nohistoryofallergies,poisoninghistory.0102Laboratorytests（实验室检查）：生化：肌酐2245umol/L,Bun88.94mol/L,co2-cp15.4mmol/L,血k7.09mmol/L。血常规：WBC9.19，HGB56g/L尿常规：白蛋白2.0g/L,WBC16.2/LB超提示：双肾缩小、声像图异常（符合肾脏疾病声像图改变），前列腺钙化，盆腹腔积液，予透析利尿，降压治疗。胸片：心影增大。Biochemical：Creatinine2245umol/L,Bun88.94mol/L,co2-cp15.4mmol/L,Potassium7.09mmol/L。Blood:WBC18.5,HGB56g/L

Urine:albumin2.0g/L,WBC16.2/LB-Tip:kidneysshrink