BACKGROUND: Fatigue is one of the most common problems experienced by chronic kidney disease (CKD) patients undergoing hemodialysis. The application of intradialytic exercises can be the best solutions to overcome fatigue related to CKD. CASE PRESENTATION: A 50-year-old male patient with CKD, who complained of severe fatigue, was selected in case study. The FACIT Fatigue Scale questionnaire and clinical indicators were measured before and after intervention. The intradialytic exercise was administered at 3rd hour of hemodialysis for 4 sessions in 2 weeks. Each session required 30 minutes, containing warming up, main exercise and cooling down. After two weeks intervention, there was an improvement of fatigue score (16 to 29) and reduction of weakness, tiredness, washout feeling, sleepy, and tiredness on eating. Moreover, the clinical indicators showed positive improvement after the intervention. CONCLUSION: Thus, intradialytic exercise is practically promising to minimize fatigue related to CKD among patients undergoing hemodialysis. Hemodialysis nurses or other health care providers could utilize this evidence as a program to reduce the fatigue related to CKD.

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The purpose of this study was to determine the effect of workload, burnout, and work conflict partially on the work stress of employees. The population in this study were employees of PT DM Baru Retailindo, precisely at the DM Baru 6 Bantul branch. Data was collected through a questionnaire and then analyzed using multiple linear regression with the help of the SPSS software application version 25.0. Based on the results of research tests found, namely: (1) Workload has a positive and significant effect on Employee Work Stress. (2) Burnout has a positive and significant effect on Employee Work Stress. (3) Work Conflict has a positive and significant effect on Employee Work Stress. (4) Workload, Burnout, and Work Conflict have a positive and significant effect on Employee Work Stress. Keywords: Workload, Burnout, Work Conflict, Employee Work Stress.

BACKGROUND: After hemodialysis, complications may occur and one of them that problematic is hemodialysis-related nausea. Information is still unclear about aromatherapy concerning nausea-related to hemodialysis. This study aimed to describe the effect of aromatherapy on nausea after hemodialysis procedures. CASE PRESENTATION: A 51-year-old female, undergoing routine hemodialysis, experienced severe hemodialysis-related nausea. Her nausea occurred a day after dialysis and existed for 3–4 days and this repeated as a cycle that affected her appetite, food intake, and general condition. The daily measurements of nausea used the visual analog scale and the nausea severity scale before and after the intervention. In addition, a manual book with a packet containing nausea education, protocol of intervention, and monitoring sheets, was provided. For two weeks, the application of two drops of lavender aromatherapy was given on a humid cotton swab and inhaled for 5 min. In addition, education explained oral hygiene using warm water when waking up in the morning and before eating food. There was a decrease in the intensity of nausea from severe to none based on daily measurements and from severe nausea (score: 21) to moderate nausea (score: 10) after the 2-weeks intervention. Thus, the patient could enjoy eating without any uncomfortable feeling of nausea. CONCLUSION: Lavender aromatherapy was demonstrated as a complementary therapy in overcoming nausea after dialysis among CKD patients. This report could provide a novel therapeutic modality for hemodialysis patients suffering hemodialysis-related nausea.

Background: Treatment of osteoporosis in hemodialysis patients is important since it slows down the worsening effect of osteoporosis and prevents bone fractures. Objective: To know the description of osteoporosis nursing management in hemodialysis patients Case description: A 62 years old male complained about his difficulty in walking, as well as back and ankle ache during strenuous activities after hemodialysis. Nursing actions were given with the aim of alleviating client complaints. Results: This study found that the patient experienced back, knee, and ankle ache during strenuous activities. Pain management -as the nursing action- was given by administering paracetamol and CaCo3 as well as joint training education to strengthen muscles. The patient's pain level was decreased after the intervention from the severe category to the moderate category (pain range 7-8 to 4-5). Conclusion: The treatment for osteoporosis in hemodialysis which includes phosphate buffer supplements, analgesic drugs, adherence to hemodialysis therapy, and muscle strengthening exercises, has pain reduction effect from severe to the moderate pain category.ABSTRAKLatar belakang: Penanganan osteoporosis pada pasien hemodialisis merupakan hal penting, agar dapat memperlambat perburukan osteoporosis dan mencegah terjadinya patah tulang. Tujuan: Mengetahui gambaran penatalaksanaan keperawatan osteoporosis pada pasien hemodialisis.Deskripsi kasus: Seorang lelaki, 62 tahun, mengeluh kesulitan berjalan, nyeri punggung, dan nyeri pada kaki saat beraktivitas berat selama 3 tahun terakhir setelah hemodialisis. Tindakan keperawatan diberikan dengan tujuan untuk meringankan keluhan klien.Hasil: Hasil pengkajian didapatkan keluhan nyeri pada punggung, pergelangan kaki dan lutut saat beraktivitas berat. Tindakan keperawatan yang diberikan berupa penanganan nyeri akut dengan pemberian obat parasetamol dan CaCo3 serta edukasi latihan persendian untuk memperkuat otot. Setelah pemberian intervensi, tingkat nyeri pasien berkurang, dari kategori berat (rentang nyeri 7-8) menjadi kategori sedang (rentang nyeri 4-5).Simpulan: Penanganan osteoporosis pada pasien hemodialisis mencakup suplemen penyangga fosfat, obat analgesik, kepatuhan terapi hemodialisis, dan penanganan non-farmakologis berupa latihan penguatan otot yang dapat memberi efek pengurangan nyeri, dari kategori nyeri berat menjadi nyeri sedang.