66 * chronic kidney disease, CKD 2012 4 12 2012 8 6 2012 63,999 hemodialysis, HD 57,615 90 peritoneal dialysis, PD 6,384 10 2012 2002 * 103 4 23 103 12 23 104 1 15 100 18ES (07) 3121101 5564 wanchun0955@hotmail.com DOI 10.3966/172674042015031401005
67 chronic kidney disease, CKD glomerular filtration rate, GFR 60 ml/1.73 m 2 /min 3 2010 GFR CKD St. Peter, Schoolwerth, McGowan, & McClellan, 2003 2004 90 ml/min/1.73 m 2 60~89 ml/min/1.73 m 2 30~59 ml/min/1.73 m 2 15~29 ml/min/1.73 m 2 15 ml/min/1.73 m 2
68 transplantation 2 silicone 2002 Bernardini, Nagy, & Piraino, 2000; Gokal & Hutchison, 2002; Raj, 2002 2004 2004 2005 2008 2004 30 39 2004 20082008 anxiety 2008 2008 2011 2012
69 30 3 2006 2010 8 16 Cr. 2010 9 2 2012 4 12 8 6 7 3 Hb9.2 g/dl Hct28.9 2006 2 2010. 8. 16 Cr. 6.5 mg/dl 2010. 9. 2 Cr. 7.47 mg/dl 5 2012. 4. 12 Cr. 8.52 mg/dl 2012. 7. 3 Cr. 10.15 mg/dl 2012. 7. 15 2012. 7. 23 2012. 7. 24 2012. 7. 28 2012. 7. 30 2012. 8. 6
70 NESP 20 mcg Hct28 167 52 18.6 kg/ 18-24 24 1,659 1,700 4-5 1,500 cc 7 3 3+ 7-8 7 24 5 0.5 1,000-1,500 cc 4 10 Na136 meq/dlk4.1 meq/dlca8.0 meq/dl P5.0 meq/dl BUN 90.6 mg/dl Cr.8.52 mg/ dl 13 2006 2010 2010 8 16 2010 9 2
71 2012 4 12 4 15 5 10 6 5 6 7 7 2 2010 8 16 30 20 7 4 7 5 7 15 7 23
7. 7/4 72 7 24 5 0.5 7 26 14-16 7 28 ) 4/12-7/24 S 1. 4/12 2. 4/12 3. 5/10 4. 6/5 5. 6/7 6. 7/2 104 3
8. 6/10 73 8. 7/5 O 1. 2. 3. 4. 1. 4/20 2. 7/14 1. 4/12 2. 4/12 3. 4/12 4. 5/10 4 4 5. 5/10 6. 5/10 7. 5/10
1. 4/21 2. 6/5 3. 7/15 PD 4. 7/4 5. 7/23 7/24 PD 7/15-7/24 S 1. 7/15 2. 7/23 3. 7/23 4. 7/24 O 1. 2. 3. 4. 144/82 mmhg88 20 7/22 74
75 1. 7/15 2. 7/15 3. 7/15 4. 7/15 5. 7/15 6. 7/23 2 7. 7/23 8. 7/23 9. 7/23 PD 1. 7/23 2. 7/24 PD 7/15-8/6 S 1. 7/28 2. 7/28 O 1. 7/24 PD
5. 8/6 76 1. 8/2 2. 8/2 1. 7/15 2. 7/15 3. 7/30 PD 10 (1) (2) (3) (4) (5) (6) (7) 4. 8/1 PD 5. 8/4 1. 8/3 2. 8/1 8/2 8/3 3. 8/4 CAPD 4. 8/3 CAPD
PD7/24-8/6 S 1. 7/26 O 1. 7/24 PD 5 0.5 4. 8/6 2. 7/25 1 cm 1 cm 77 1. 7/31 3 2. 8/6 3. 8/6 1. 7/25 2. 7/25 3. 7/26 2 4. 7/26 5. 7/26 6. 7/27 1. 7/31 2. 7/31 3. 8/3 104 3
78 8 6 2004 2012 8 21 100 http://www.nhi.gov.tw/resource/ Webdata/24443_2_21778_2_100-0821.pdf 2004 Orem 3 152-63 2004 16 4241-246 2002 11 2004 Orem 3 142-50 2005 10 3 9-14 2008 7 365-70 2008 7 21-6 2004 105 367-381 2004 3 281-87 2002 19 190-99 2011
79 10 131-40 2010 906-920 2008 7 146-59 2008 7 222-33 2012 11 473-85 Bernardini, J., Nagy, M., & Piraino, B. (2000). Pattern of noncompliance with dialysis exchanges in peritoneal dialysis patients. American Journal of Kidney Diseases, 35(6), 1104-1110. Gokal, R., & Hutchison, A. (2002). Dialysis therapies for end-stage renal disease. Seminars in Dialysis, 15(4), 220-226. Raj, D. S. C. (2002). Role of APD in compliance with therapy. Seminars in Dialysis, 15(6), 434-436. St. Peter, W. L., Schoolwerth, A. C., McGowan, T., McClellan, W. M. (2003). Chronic kidney disease: Issues and establishing programs and clinics for improved patient outcomes. American Journal of Kidney Diseases, 41(5), 903-924.
80 Nursing Experience of a Chronic Kidney Disease Patient Receiving Peritoneal Dialysis Jui-Hsin Chen Chiu-Yueh Chen Wan-Chun Liao * Abstract The subject is a young married woman with chronic kidney disease (CKD) whose parents were both on hemodialysis. This report described how communication and coordination was used to gain the support and understanding of her family when she was faced with choice of renal replacement therapy or Tenckhoff catheter implantation for peritoneal dialysis (PD). Between April 12 and August 6, 2012, the author, a CKD education nurse, found through global evaluation using Roy adaptation model that the patient was experiencing health problems such as anxiety, conflicting choices, health seeking behavior and potential infection risks. Through suitable, comprehensive and continuous nursing care measures such as listening, active care and support, we assisted the patient with receiving the facts on long-term dialysis, accepting her choice of dialysis modality and actively engaging in PD self-care. Through timely encouragement, explanation by doctors and clarification of problems, the physical and psychological problems were overcome. The patient was able to enter dialysis treatment successfully without incident and approach the prospect of living with long-term dialysis with a healthy attitude. Key words: chronic kidney disease, renal replacement therapy, the conflict of the choice Department of Nursing, Kaohsiung Municipal Hsiao-Kang Hospital Department of Nursing, Kaohsiung Medical University Chung-Ho Memorial Hospital * Received: Apr. 23, 2014 Revised: Dec. 23, 2014 Accepted for publication: Jan. 15, 2015 Correspondence: Wan-Chun Liao No. 100, Ziyou 1st Rd., Sanmin Dist., Kaohsiung City 807, Taiwan (R.O.C.) Telephone: (07) 3121101 ext. 5564 E-mail: wanchun0955@hotmail.com DOI: 10.3966/172674042015031401005