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Reducing complications during hemodialysis using gradient ultrafiltration with gradient sodium dialysate. 梯度透析钠梯度超滤减少血液透析并发症。
ANNA journal Pub Date : 1999-10-01
C Meers, E B Toffelmire, M McMurray, W Hopman
{"title":"Reducing complications during hemodialysis using gradient ultrafiltration with gradient sodium dialysate.","authors":"C Meers,&nbsp;E B Toffelmire,&nbsp;M McMurray,&nbsp;W Hopman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The objective of this study was to determine if patient complications and nursing interventions during hemodialysis could be reduced using gradient ultrafiltration and gradient sodium dialysate. Twenty outpatients who had been on hemodialysis for at least 3 months, and using gradient sodium dialysate for at least 1 month, participated. Patients received either ultrafiltration at a constant hourly rate or gradient ultrafiltration, in which the ultrafiltration rate was set higher initially, then decreased step-wise mid-dialysis. Patients received each protocol for 3 months, using a randomized cross-over design. Both protocols used gradient sodium dialysate (150 mEq/L x 3 hrs, 140 mEq/L x 1 hr). There were significantly fewer complications and interventions using gradient ultrafiltration, as compared to constant ultrafiltration. No differences were found in interdialytic weight gain, intradialytic weight loss, or orthostatic blood pressure. These results indicate that gradient ultrafiltration combined with gradient sodium dialysate enhances patient well-being and reduces nursing interventions during hemodialysis.</p>","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 5","pages":"495-500; discussion 501, 505"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21624763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Iron management: innovative solutions to persistent challenges--focus on Ferrlecit. 铁管理:创新的解决方案，持续的挑战-专注于ferlecit。
ANNA journal Pub Date : 1999-10-01
S Vogel, S Schweitzer, S Seiler
{"title":"Iron management: innovative solutions to persistent challenges--focus on Ferrlecit.","authors":"S Vogel,&nbsp;S Schweitzer,&nbsp;S Seiler","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The use of sodium ferric gluconate in sucrose injection (Ferrlecit) in the treatment of anemia in patients with end stage renal disease (ESRD) was the major topic at the symposium \"Iron Management: Innovative Solutions to Persistent Challenges,\" held April 14, 1999 during the annual ANNA 30th National Symposium in Baltimore, Maryland. Chairperson Susan Vogel, MHA, RN, CNN, addressed the challenges of anemia management and the limitations of oral iron supplements. She described available intravenous (i.v.) iron therapies and reviewed clinical trial data that demonstrated an excellent safety and efficacy profile for the newly approved i.v. iron supplement, sodium ferric gluconate. Suzanne Schweitzer, RPh, MPH, discussed iron metabolism and the U.S. labeling for sodium ferric gluconate, with a focus on dosing and administration. In the final presentation, Suzanne Seiler, RN, described her clinic's experience with sodium ferric gluconate and provided an experimental dosing and monitoring protocol. Together, these presentations suggest that sodium ferric gluconate is an important new tool for meeting the challenges of iron management in ESRD patients.</p>","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 5","pages":"515-21"},"PeriodicalIF":0.0,"publicationDate":"1999-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21626052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The relationship between dialysis adequacies and sleep problems in hemodialysis patients. 血液透析患者透析充分性与睡眠问题的关系
ANNA journal Pub Date : 1999-08-01
M Puntriano
{"title":"The relationship between dialysis adequacies and sleep problems in hemodialysis patients.","authors":"M Puntriano","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This research examined the relationship between the incidence of sleep problems and hemodialysis adequacy (Kt/V) in hemodialysis patients. In addition, this study identified demographic variables that may be related to sleep problems of hemodialysis patients. The research design was cross-sectional, descriptive, and correlational. A convenience sample (n = 50) included 25 male and 25 female hemodialysis subjects from a private, for profit ambulatory dialysis clinic. The primary researcher interviewed subjects using a questionnaire that included demographics and questions regarding sleep habits. Two significant results were found. For subjects in the study aged 65 and older, increased dialysis adequacies were associated with a decreased number of awakenings at night. Second, women, regardless of age and education, reported using more sleep medications than men. Overall, this study did not find a relationship between sleep problems and dialysis adequacies. Further research is needed to increase awareness and understanding of the complexities of sleep problems in renal patients.</p>","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 4","pages":"405-7"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21682940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Managing anemia using laboratory trend analysis. Case study of the anemic patient. 利用实验室趋势分析管理贫血。贫血病人的个案研究。
ANNA journal Pub Date : 1999-08-01
J Aiello
{"title":"Managing anemia using laboratory trend analysis. Case study of the anemic patient.","authors":"J Aiello","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Proper management of the anemia of end-stage renal disease (ESRD) requires chronic monitoring of an interrelated set of variables that can affect the erythrokinetic response. In most cases, therapeutic interventions should be determined on the basis of serial trends in laboratory values, thereby providing a historical pattern of clinical response. This article reviews the rationale for using laboratory trend analysis to manage anemia. A methodology for categorizing patterns in hemoglobin and hematocrit response to identify probable causes of hypo- or hyper-response to Epoetin alfa therapy is provided.</p>","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 4","pages":"430-3"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21683438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Will nephrology nursing survive managed care? 肾内科护理能否在管理式护理中存活?
ANNA journal Pub Date : 1999-08-01
H Danko
{"title":"Will nephrology nursing survive managed care?","authors":"H Danko","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 4","pages":"454"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21683440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
President's message. Governance of ANNA. 总统的消息。ANNA的治理。
ANNA journal Pub Date : 1999-08-01
P Weiskittel
{"title":"President's message. Governance of ANNA.","authors":"P Weiskittel","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 4","pages":"372, 452"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21682931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Hearing the silence of patients who did not receive an anticipated organ transplant: "being second in line". 听到没有接受预期器官移植的病人的沉默:“排在第二位”。
ANNA journal Pub Date : 1999-08-01
R S Sloan, J Gittings
{"title":"Hearing the silence of patients who did not receive an anticipated organ transplant: \"being second in line\".","authors":"R S Sloan,&nbsp;J Gittings","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Admitting more than one potential organ recipient for a single available kidney is a common practice, resulting in one patient leaving the hospital without an anticipated organ transplant. The purpose of this study was to understand the life-world of end stage renal disease (ESRD) patients and their family members who experienced the phenomenon of \"being second in line\" for an anticipated renal transplant. After informed consent was given, indepth, face-to-face interviews were conducted with ESRD patients or family members. Interviews with 18 ESRD patients or family members who had experienced the phenomenon of leaving the hospital without an anticipated organ transplant were included in this study. The study was conducted in an mid-South university-based urban clinic that provided a variety of treatment services for dialysis and transplant patients. The narratives were tape recorded and transcribed verbatim by the researchers or a trained medical secretary. Hermeneutical analysis was used to bring forward themes found in these narratives. These narratives allowed patients and families to describe for themselves the lived experience of this event. Themes from the narratives included (a) knowing and not knowing; (b) having high hopes for a life without dialysis; (c) wanting the transplant, but not at the expense of someone else; and (d) having no voice for your experience. The final theme presented itself in three ways: (a) silencing the experience, (b) reframing by others as a \"learning experience,\" and (c) reframing by others as a \"misunderstanding.\" Data from this study do not support stopping the procedure of notifying more than one potential organ recipient about an available kidney, only that this is an important and meaningful experience unique to ESRD patients and their families.</p>","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 4","pages":"375-9, 448; discussion 380, 444"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21682933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acquired cystic kidney disease in ESRD. ESRD患者的后天性囊性肾病。
ANNA journal Pub Date : 1999-08-01
C M Headley, B Wall
{"title":"Acquired cystic kidney disease in ESRD.","authors":"C M Headley,&nbsp;B Wall","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acquired cystic kidney disease (ACKD) in patients undergoing dialysis has been associated with life-threatening complications. Potential malignant transformation of the cysts has prompted concern regarding the need to screen patients for ACKD. The assumed increased morbidity associated with malignant transformation has not been clearly documented in the literature and may require further long-term analysis to adequately assess. Many reports on ACKD refer to the risk for malignancy, but other complications associated with ACKD may also arise. The development of ACKD has been shown to increase with increasing time on dialysis. Patients on dialysis appear to have a longer life expectancy and, consequently, more will develop ACKD. Complications related to ACKD may increase, which bolster efforts to establish specific guidelines related to the screening and management of ACKD. Nephrology nurses should be aware of symptoms suggesting a complication related to ACKD and confer with the nephrologist regarding evaluation. This article will discuss implications and management related to an increasing incidence of ACKD.</p>","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 4","pages":"381-7; quiz 388-9"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21682934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Aluminum toxicity in the 1990s. 90年代的铝中毒。
ANNA journal Pub Date : 1999-08-01
J H Kosier
{"title":"Aluminum toxicity in the 1990s.","authors":"J H Kosier","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 4","pages":"423-4"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21682943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Methicillin-resistant staphylococcus aureus infection. 耐甲氧西林金黄色葡萄球菌感染。
ANNA journal Pub Date : 1999-08-01 DOI: 10.32388/otlffp
J. Briggs
{"title":"Methicillin-resistant staphylococcus aureus infection.","authors":"J. Briggs","doi":"10.32388/otlffp","DOIUrl":"https://doi.org/10.32388/otlffp","url":null,"abstract":"","PeriodicalId":76998,"journal":{"name":"ANNA journal","volume":"26 4 1","pages":"425"},"PeriodicalIF":0.0,"publicationDate":"1999-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69638621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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