Nursing care for patients with chronic kidney disease stage 4 at home : a comparative Case study.

Abstract

      This study was comparison of two case studies aimed to study and compare the disease progression, treatment, and nursing care for 2 patients with chronic kidney disease stage 4 at home who received treatment at Nonghee Hospital. This case study compared 2 patients with chronic kidney disease stage 4. The study was conducted in case study 1 who received services at Nonghee Hospital on May 7, 2024, and in case study 2 on July 30, 2024. Data were collected using interviews, observations, and medical records. The concept of patient health assessment according to the 11 health models of Gordon and the INHOMESSS assessment form was used, and nursing diagnoses were determined along with the concept of nursing process to apply to continuous nursing care for patients at home.

     Main findings : Case study 1, a 72-year-old Thai man, had chronic kidney disease stage 4 4 ​​years ago and had hypertension and gout. Case study 2: A 70-year-old Thai man with stage 4 chronic kidney disease who had gout 2 years ago. From 4 home visits, the nursing diagnosis was the same: there was a state of waste accumulation and an imbalance of fluids and electrolytes in the body due to decreased renal filtration and loss of kidney function, anemia due to stage 4 renal failure, the patient and relatives were anxious about the disease due to lack of knowledge about the disease and behavior, and a risk of stroke. Providing continuous holistic nursing care at home resulted in no complications for both patients and was able to reduce the progression to end-stage renal disease.