Nursing Care for Leptospirosis-Associated Acute Renal Failure Patients Requiring Hemodialysis: A Report of Two Cases
Keywords:
leptospirosis, hemodialysis, nursing care, acute renal failureAbstract
Leptospirosis is a disease caused by infection with bacteria. Acute severe infection induces multiple organ dysfunctions including acute kidney injury and may predispose to causing acute renal failure, if not treated timely. To be a guideline for nursing care in acute renal failure of leptospirosis patients requiring hemodialysis. Two case studies between May to August 2019 will be presented.
Case Study 1 : A 49-year-old male patient gave a history of 7 days before coming to the hospital with fever, aches, aching pain, calf pain, fatigue, yellow eyes, blurred vision. Physician made a diagnose leptospirosis associated acute renal failure. Have a treatment plan for hemodialysis, but patient and relatives refused. He presented dyspnea in following days. On the 8thday of treatment, the patient presented acidosis and received renal support with hemodialysis for 1 time, less than 2 hours. He had severe hypotension while hemodialysis, heart failure and death finally. He was hospitalized for 9 days.
Case study 2 : A 44-year-old male patient gave a history of 5 days before coming to the hospital with fever, body aches, yellow eyes, diarrhea, low volume, tiredness, feeling unable to breath. Physician made a diagnose leptospirosis associated acute renal failure.
There is a treatment plan for giving the antibiotic and normal saline. The symptoms did not improve. On the 5thday of the treatment, the patient presented dyspnea, and acidosis. Hemodialysis treatment was done 2 times without complications. He was hospitalized for 12 days and was discharged.
The results of the study showed that recovery kidney function, reduce complications and survival of patients with acute renal failure in leptospirosis depend on early and appropriate supportive treatment, which also include hemodialysis. Therefore, nurses should have knowledge, experience and standard nursing practice guidelines for taking care of patients to provide efficacy outcome and safe from various complications.
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