What are the dialysis catheter care measures? Care of hemodialysis patients

Hemodialysis. The catheters are divided into long-term catheters and temporary catheters, which can be divided into neck catheters and leg catheters according to the location of the catheter. The most common problem with hemodialysis catheters is infection, so in terms of care:

1. Do not touch the outer end of the catheter with your own hands. 2. When washing hair or bathing, pay attention to avoid water entering the inside of the catheter or the outer end of the catheter. 3. If the catheter is in the leg, try to minimize the activity of the leg to avoid infection of the catheter bending.

A common problem with hemodialysis catheters is the breakage of sutures to avoid excessive traction of the catheter. Catheters may be susceptible to the formation of blood clots, especially temporary catheters, which may be more susceptible to the formation of blood clots. At this time, it should be noted that the temporary catheter should be replaced regularly, or replaced with a long-term catheter or mobile venous fistula.

If the catheter is poorly aspirated, sodium heparin may be used.

Perform tube sealing.

What are the nursing measures for long-term indwelling catheter blood dialysis 1, record the length of the catheter outside the body, fix it, and inform the patient that the action on the side of the catheter is not too large to prevent it from falling out. 2. Strictly grasp the principle of sterility when changing dressings, and cover them with sterile gauze or paste dressings after dressing changes in the first half month of implantation. Before 3 Jie patients, the arteries and veins were each used with a 5ml syringe to withdraw 2ml of the tube sealing solution, and if the pumping was not smooth, urokinase should be used for thrombolysis, and if there was resistance, it should not be forcibly pushed in; When sealing the tube, the arteriovenous side first pushes back the blood with 20ml of saline pulse, and then seals the tube with sealing solution to ensure positive pressure.

It is recommended to dissolve thrombolysis with urokinase 1-2 times a month. 4. Try not to use the catheter for other purposes. Except for rescue.

Nursing measures: The monitoring content in hemodialysis includes four aspects: the observation of patients' vital signs, mental status, emergency complications of hemodialysis, vascular access monitoring, extracorporeal bypass monitoring and dialysate fluid path (also known as waterway).

Observation and monitoring of the patient's condition.

Body temperature is usually measured once before dialysis and once before the end of dialysis, and recorded on the hemodialysis care record.

Pulse, blood pressure, and respiration Blood pressure monitoring is especially important in monitoring changes in vital signs. Understand the causes of hypotension, try to avoid them, and find them in time and deal with them in time. Patients with high blood pressure should be given as prescribed.

If the systolic blood pressure exceeds 200 mmHg and oral antihypertensive drugs are ineffective, nitroprusside can be used for continuous intravenous infusion, and dialysis should be terminated in particularly severe patients.

Mental status The symptoms of irritability, headache, blurred vision, drowsiness, coma, etc., are mostly related to complications such as dialysis imbalance syndrome, air embolism, hypoglycemia, hypotension, severe arrhythmia, or cardiovascular accident. In addition, the above situation is also prone to rapid and excessive ultrafiltration. Nursing records should be kept closely observed.

1) Before dialysis: explain the purpose, process and possible problems of dialysis to the patient to avoid tension and increase the sense of security.

2) Dialysis: observe the changes in the patient's consciousness, blood pressure, pulse, respiration, body temperature, and **, and pay attention to the occurrence of bleeding, hypotension, allergies, and imbalance syndrome; Pay attention to aseptic operation hypopermeation; Establish vascular access and fix it properly; Reasonably adjust and set the parameters of the dialysis machine to observe whether the equipment is operating normally; Fill in the dialysis record form, record the dialysis time, the amount of ultrafiltration liquid, the type of anticoagulant, the dose, etc.

3) After dialysis: observe whether the patient's general condition improves; Blood samples are collected for laboratory testing to understand the efficacy of dialysis; Remove the catheter, compress and stop the bleeding, the location should be accurate, the time should be sufficient, and pay attention to the empty spike to observe whether there is bleeding and hematoma in the locality; If the catheter needs to be retained, the catheter should be sealed with heparin saline.

1. Record the length of the catheter outside the body, fix it, and inform the patient that the action on the side of the catheter is not too large to prevent it from falling out.

2. Strictly grasp the principle of sterility when changing dressings, in the first half of the month just implanted, Hongling should be covered with sterile gauze after dressing change, or pasted with dressings.

Before 3 Jie patients, the arteries and veins were each used with a 5ml syringe to withdraw 2ml of the tube sealing solution, and if the pumping was not smooth, urokinase should be used for thrombolysis, and if there was resistance, it should not be forcibly pushed in; When sealing the catheter, the arteriovenous side first pushes back the blood with 20ml of saline pulse, and then seals the tube with sealing solution to ensure that the closed fissure pressure is being searched. It is recommended to dissolve thrombolysis with urokinase 1-2 times a month.

4. Try not to use the catheter for other purposes. Except for rescue.

Hemodialysis is a type of blood purification technology that plays a very important role in reducing symptoms and prolonging survival in patients with kidney disease. In addition to having a professional staff take care of the patient in the hospital, the daily care of the family is equally important. The following points should be paid attention to in the diet.

Pay attention to the control of water intake. The amount of water intake is important for dialysis patients. In order to avoid too much weight gain, it is recommended to control the daily water intake within 5% of the net body weight, because uremia patients, urine output will be reduced, and the removal of water mainly depends on dialysis, so the intake of drinks and soups should be limited, and the cooking of dishes can be thickened to increase the smoothness.

Lowers blood lipids. Hyperlipidemia is the main cause of cardiovascular disease in dialysis patients, so boiling, steaming, and blanching should be used in cooking, and cooking methods containing high sugar, high oil, and high salt such as honey, sweet and sour, ketchup, frying, and frying should be avoided, and olive oil rich in monounsaturated fatty acids and has the function of reducing blood lipids can be used. Reduces potassium, phosphorus, and sodium electrolyte intake.

Excessive potassium intake will cause hyperkalemia, arrhythmia, heart failure in dialysis patients, and hyperphosphatemia will cause hyperparathyroidism in dialysis patients, which will also make them itchy. Therefore, vegetables can be blanched before cooking to reduce potassium intake, and dried fruits such as pistachios are rich in phosphorus and should be eaten sparingly. Salt intake should be limited to prevent high blood pressure and heart failure.

Pay attention to the absorption of high-quality proteins. Because the process of dialysis is to drain the blood containing toxins to the dialysis machine through the arteriovenous fistula and then flow back to the body, protein will be lost in the process, so the intake of protein is mainly based on high-quality animal protein, such as: eggs, milk, fish, lean meat, etc., and the daily diet should also pay attention to foods that supplement iron, calcium, zinc, vitamin B and vitamin C, and you can also take in an appropriate amount of sugar to increase calories.

In addition, if dialysis patients have constipation, their blood potassium is more likely to be high, and intake of high-fiber foods at this time can not only improve constipation but also improve hyperlipidemia. All in all, grasping the principles of high-quality protein, appropriate calories, low cholesterol, low phosphorus, low potassium, high iron, high-fiber diet, and water restriction can make dialysis patients healthier. In addition to this, it is done:

Pay attention to psychological counseling. Psychological counseling and the creation of a good family atmosphere will make dialysis patients feel happy and warm. Because some dialysis patients will be accompanied by different degrees of other organ damage, blindness, neuritis, cardiac insufficiency and other complications, so that their physical and mental pain is indescribable, often leading to their temper and depression.

In daily life, we should observe more, ask more, comfort more, encourage more, communicate more, and provide psychological guidance for dialysis patients, so that they can relax their spirits and become more relaxed as soon as possible. Blood pressure is measured regularly. The pathogenesis of hypertension in patients receiving hemodialysis for a long time** is multifactorial, and blood pressure measurements should be taken regularly and repeatedly in home care to monitor the physical condition of dialysis patients and grasp the patient's condition.

Focus on physical activity. It is necessary to pay attention to the cleanliness of the patient's body, maintain a good attitude towards life, actively participate in physical exercise, and pay attention to the increase or decrease of clothes during the change of seasons. Get enough sleep.

1.The patient's lack of care in the hemodialysis room is dominated by patients and is also the most difficult to manage.

2.It is important to strengthen the professional knowledge training and skills training of nursing staff.

3.Strengthen nursing safety management to reduce nursing complications while increasing patient trust.

4.Surveillance of hospital infections.

5.Strictly implement handover, multi-inspection, etc.