A Case Study on Nursing Care for a Diabetic Patient with Hypoglycemia and End-Stage Renal Disease Undergoing Peritoneal Dialysis.

Abstract

     This case study aimed to explore the nursing care of a diabetic patient with hypoglycemia and end-stage renal disease (ESRD) undergoing peritoneal dialysis. The case involved a 63-year-old Thai male with multiple comorbidities, including type 2 diabetes mellitus (30 years), hypertension (10 years), and stage 5 chronic kidney disease (3 years), who had been receiving peritoneal dialysis for one year. He was admitted to the hospital due to drowsiness, dizziness, and near fainting approximately 30 minutes before arrival.

     Result: The physician diagnosed him with hypoglycemic coma accompanied by an infection. Nursing care was provided continuously throughout all phases of treatment: pre-assessment, during examination, post-examination, follow-up visits, and discharge planning. The focus was on comprehensive assessment based on Gordon's functional health patterns, covering physical, psychological, and behavioral aspects. Emphasis was also placed on patient education, behavior modification, and prevention of future complications. Nursing interventions included correcting hypoglycemia, preventing recurrence, managing infection around the knee joint and the Tenckhoff catheter site, and preparing for discharge using the DMETHOD approach to prevent re-admission. Psychological support was also provided to both the patient and his family.