Prevalence of nursing diagnosis of fluid volume excess in patients undergoing hemodialysis

Abstract

Objective: To identify the prevalence of nursing diagnosis of fluid volume excess and their defining characteristics in hemodialysis patients and the association between them. Method: Cross-sectional study conducted in two steps. We interviewed 100 patients between the months of December 2012 and April 2013 in a teaching hospital and one hemodialysis clinic. The inference was performed by diagnostician nurses between July and September 2013. Results: The diagnostic studied was identified in 82% of patients. The characteristics that were statistically associated: bounding pulses, pulmonary congestion, jugular vein distention, edema, change in electrolytes, weight gain, intake greater than output and abnormal breath sounds. Among these, edema and weight gain had the highest chances for the development of this diagnostic. Conclusion: The analyzed diagnostic is prevalent in this population and eight characteristics presented significant association.

Nursing diagnosis in older adults with chronic kidney disease on hemodialysis

“…The ND of Excessive fluid volume were also present in all the older adults, confirming the literature -for example, according to Fernandes (2014), the accumulation of fluids is a frequent finding in hemodialysis patients (21) . Cavalcanti (2015) noted in his study that the ND of Excessive fluid volume had a higher incidence in older women who presented clinical conditions such as SAH and DM, a result also noticed in our analysis.…”

“…This can be explained by the fact that blood pressure is directly related to the homeostasis of bodily fluid, which is maintained by the relationship between the volume of ingested and eliminated liquids, and this balance is regulated by the nervous system, hormone controls and by the kidneys. Thus, once the glomerular filtration rate is lower or null in patients with CKD, the elimination of fluids and electrolytes becomes inefficient, causing accumulation in the body and causing increased blood pressure in the interdialytic period (21)(22) . Being older adults the patients on hemodialysis with lower rate of survival and considering the frequent presence of the ND Excessive fluid volume, it is noted the need for early identification and effective management based on scientific knowledge of this diagnosis by the health team, since the body fluid overload in interdialytic period may cause edemas -among them, acute pulmonary edema, which is a common cause of hospitalization of older adult patients on hemodialysis (21)(22) .…”

Enfermeiros atuantes em hemodiálise indicam diagnósticos de enfermagem relevantes na prática clínica

“…(15) Among these patients, the mortality rate caused by infection after five years is 57%. (16) Risk for bleeding was described with a prevalence of 100%, (9) indicating that it should receive greater attention from professionals and researchers. (9,10) Risk for bleeding is directly related to platelet disorders, which prolong bleeding time.…”

“…(17) Risk for shock was also considered relevant, in agreement with the findings of studies that identified this diagnosis with a prevalence of 100%. (9) Risk for falls has also been reported, (1,2) which can be caused by the hemodynamic oscillations that occur during hemodialysis. (13,14) Risk for allergy response was a highly valued diagnosis (RI=0.80).…”

“…Only ineffective therapeutic regimen was studied, indicated by nursing professionals in another context as one of the most relevant diagnoses. (3) Among the nursing diagnoses indicated as relevant to hemodialysis clinical practice with RI ≥0.75 and ≤ 0.79, approximately half have been studied in terms of their occurrence: impaired tissue integrity, (3) ineffective self-health management, (9) impaired urinary elimination, (9) risk for loneliness, (8) activity intolerance, (8) anxiety, (9) sexual dysfunction, (1,12) constipation, (12) ineffective sexuality pattern, (8,12) impaired sleep pattern, (8,11) and risk for imbalanced nutrition: more than body requirements. (8,12) The occurrence of the other diagnoses has not yet been addressed in nursing studies.…”