Nursing diagnoses of patients with kidney disease undergoing hemodialysis: a cross-sectional study

Spigolon, Dandara Novakowski; Teston, Elen Ferraz; Souza, Fábio de Oliveira; Santos, Bruna dos; Souza, Rebeca Rosa de; Moreira Neto, Antônio

doi:10.1590/0034-7167-2017-0225

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RESEARCH • Rev. Bras. Enferm. 71 (4) • Jul-Aug 2018 • https://doi.org/10.1590/0034-7167-2017-0225 copy

Nursing diagnoses of patients with kidney disease undergoing hemodialysis: a cross-sectional study

Diagnósticos de enfermería de portadores de enfermedad renal en hemodiálisis: un estudio transversal

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to identify Nursing Diagnoses of 5^th stage chronic kidney disease patients undergoing hemodialysis.

Method:

cross-sectional, descriptive and quantitative study carried out with 151 patients undergoing hemodialysis in a clinic specialized in nephrology from the Northwest of the Paraná State. Nursing Diagnoses were determined through Nanda-I in which had the percentage greater than 50%. The analysis used was the simple statistics.

Results:

17 Nursing Diagnoses were identified, emphasizing the risks present in 100% of patients: risks for electrolyte imbalance; ineffective kidney perfusion; infection: vascular injuries, adverse response to the iodine-based contrast-enhanced and impaired urinary elimination.

Conclusion:

the main diagnoses listed reflect the more frequent risks that patients undergoing hemodialysis are exposed to. Being aware of these risks allows the nursing planning with early interventions, in order to prevent complications related to the disease and to promote best life conditions.

Descriptors:
Nursing Diagnosis; Kidney Dialysis; Chronic Kidney Disease; Nursing Processes; Renal Replacement Therapy

Characteristics	n	%
Male	96	63.3
Age above 60 years	75	49.6
Married	84	55.6
Incomplete elementary education	82	54.3
Retired	66	43.7
Receive Illness-Aid	54	35.8
Monthly income of up to two minimum wages	100	66.2
Type of dialysis funding by the Brazilian Unified Health System (SUS)	141	93.4
Presented Systemic Arterial Hypertension	58	38.4
Presented Systemic Arterial Hypertesnion with diabetes mellitus	51	33.8

Identified Nursing Diagnoses	Individuals (N=151)
Identified Nursing Diagnoses	n	%
Sedentary life style	86	57.0
Provision for improved nutrition	82	54.3
Ineffective protection	122	80.8
Risk of electrolyte imbalance	151	100.0
Risk of dysfunctional gastrointestinal motility	89	58.9
Risk of impaired cardiovascular function	131	86.8
Risk of ineffective gastrointestinal perfusion	135	89.4
Risk of ineffective kidney perfusion	151	100.0
Risk of ineffective peripheral tissue perfusion	116	76.8
Risk of decreased cardiac tissue perfusion	109	72.2
Risk of ineffective cerebral tissue perfusion	94	62.3
Risk of adverse response to the iodine-based contrast-enhanced	151	100.0
Risk of infection	151	100.0
Risk of vascular injury	151	100.0
Risk of falls	76	50.3
Impaired urinary elimination	151	100.0
Chronic pain	82	54.3

Domain (Class)	Nursing Diagnoses	Defining characteristics, related factors and risk factors
Health Promotion (Health Perception)	Sedenary lifestyle	Poor knowledge about the benefits that physical activity brings to health.
Health Promotion (Health Control)	Ineffective protection	Old age, abnormal blood profiles, medicine therapies and/or side effects.
Nutrition (Ingestion)	Provision for improved nutrition	Expresses desire for improvement in nutrition.
Nutrition (Hydration)	Risk of electrolyte imbalance	Excessive or insufficient fluid volume, renal dysfunction and treatment regimen.
Elimination and Exchange (Gastrointestinal function)	Risk of dysfunctional gastrointestinal motility	Anxiety, chronic disease, immobility and medicines.
Activity/Rest (Cardiovascular /Pulmonary responses)	Risk of impaired cardiovascular function	Age ≥ 65 years, chronic diseases, dyslipidemia, family history of cardiovascular disease, smoking, history of cardiovascular disease and sedentary lifestyle.
	Risk of ineffective gastrointestinal perfusion	Anemia, vascular/circulatory disease, renal disease, smoking and treatment regimen.
	Risk of ineffective kidney perfusion	Kidney disease.
	Risk of ineffective peripheral tissue perfusion	Diabetes mellitus, hypertension, sedentary lifestyle and smoking.
	Risk of decreased cardiac tissue perfusion	Cardiovascular surgery, diabetes mellitus, family history of cardiovascular disease, hyperlipidemia and hypertension.
	Risk of ineffective cerebral tissue perfusion	Hypercholesterolemia and hypertension.
Safety/Protection (Deffensive Processes)	Risk of adverse response to the iodine-based contrast-enhanced	Chronic kidney disease.
Safety/Protection Infection	Risk of infection	Invasive procedure, alteration in skin integrity, smoking and chronic disease.
Safety/Protection (Injury)	Risk of vascular injury	Presence of catheter.
Safety/Protection (Injury)	Risk of falls	Age> 65 years, weakness, anemia, walking difficulties and visual difficulties.
Elimination and Exchange (Urinary function)	Impaired urinary elimination	Several reasons.
Comfort (Physical comfort)	Chronic pain	Chronic condition and fatigue.

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[1] CORRESPONDING AUTHOR: Dandara Novakowski Spigolon. E-mail: dandaraspigolon@gmail.com