臨牀透析 Vol.24 No.11(2-4-3)


特集名 高齢透析患者への看護実践 -- 認定・指導看護師からの報告
題名 [ケース別にみた看護展開]高齢維持透析患者の看護問題と対策 (3) 透析中の安全管理
発刊年月 2008年 10月
著者 松岡 由美子 御徒町腎クリニック・看護師
【 要旨 】 高齢透析患者は,生理的な身体・精神機能の衰えや自律神経障害,心機能低下に加え,動脈硬化や異所性石灰化を基盤とする心血管系合併症や潜在的心不全を有していることが多く,循環動態に影響をきたしやすい.透析による循環動態の変化は,血圧の低下や不整脈を招くこともあり,時には重篤な状態に陥る危険もある.さらに,免疫力低下や低栄養状態により易感染であるが,症状の出現が緩慢で自覚症状も感じにくいため,難治性,重症化するケースも少なくない.日常から微細な観察が必要であり,異常の早期発見・対処が重要となる.
また,安全で安楽な安定した透析療法を提供できるような透析技術が必要である.
Theme Nursing Practices for Elderly Dialysis Patients -- Report from Expert Nurses
Title [Case report] Safe treatment of elderly dialysis patients
Author Yumiko Matsuoka Department of Nursing, Keishokai Okachimachi Kidney Clinic
[ Summary ] Circulatory conditions in elderly patients can be easily affected by dialysis, due to deteriorating physical and mental health, autonomic disorders, cardiac depression, cardiovascular complications or heart failure associated with arterial sclerosis or ectopic calcification. The changes in their circulatory dynamics during dialysis treatment may cause these patients to suffer from low blood pressure or irregular heart beat and sometimes fall into serious conditions. Furthermore, even though weakened immune systems and low nutrient conditions always expose these patients to infection, they neither show symptoms of infection quickly nor feel pain. Their conditions often become more serious and difficult to treat. Therefore, we must observe elderly patients receiving dialysis very carefully in order to find and cope with any complications as soon as possible. It is also absolutely necessary to make use of safe and reliable dialysis technology.
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