PATIENTS UNDERGOING HEMODIALYSIS

8/11/2019 PATIENTS UNDERGOING HEMODIALYSIS

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CHAPTER-I

INTRODUCTION

1.1 Background of the StudChronic renal failure is a progressive reduction in the ability of kidney to remove waste

and maintain homeostasis, it is permanent reduction in the glomerular filtration rate

(GFR) sufficient to produce dectable alteration in wellbeing and organ function.CRF

affects on total body system and if not treated, ultimately leads to death (lack and

!acobs, "##$).CRF is clinical hematological and biochemical state which results from

progressive nephron loss (renner and Rocter, %&&&).

'en and women are eually affected by this problem .he incidence is highest among

middle aged people. *iabetes and hypertension are the most common cause of the

chronic renal failure, accounting over +& of the clients send the dialysis (lack and

!acobs, "##$).

-ocal eperts in /epal estimated that approimately %.+ million populations could be

suffering from some degree of kidney illness. 0ut of this, approimately %+&& people

might have suffered from chronic renal failure. 1pproimately +&& to ",&&& patients with

chronic kidney failure attend the hospitals every year. 2uoting the version of the kidney

care specialists, Gorkhapatra further stated that there are more than "&,&&& 34R* patients

in recent days. he higher prevalence of renal failure cases is found to be in urban

population .5n fact, kidney failure is a severe medical, social aid economic problem of

patients their families and entire health care system. 5t is more serious in the developing

nations including /epal, where there is a severe shortage of nephrologists, trained nurse,

high cost of care and 6ust a few institutes and hospitals offering dialysis service (*ulal,%&&7).

CRF is not curable but treatable disease. reatment includes renal replacement therapy,

dialysis (hemodialysis, peritoneal dialysis and continue ambulatory peritoneal

dialysis).he economic burden does not only affect individual but also the family and

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entire nation of the 8 lakhs patient receiving renal replacement therapy in the 9nited

4tates, %% lakhs receive dialysis therapy and remainder depend on a successful kidney

graft. he current annual increase in the number of patient receiving RR is +:7

(;er


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1.$ State%ent of the Pro&"e%

Globally, morbidity and mortality from kidney disease are increasing steadily. @revalence

of co:morbidities among patients living with chronic kidney failure is large. *iabetes and

hypertension here become more and more prevalent in every household particularly in

aged 8= and among urban residents, (;imal %:"=:%&&=)

1s CRF is not curable, it is a chronic and progressive disease. 5tBs not possible to admit

CRF patients lifelong. 34R* necessitating treatment by hemodialysis or transplantation

to survive, this is a stressful life event that has impact on physiological, psychological

and social levels (www.dialysispatients.org).

he cumulative global cost for dialysis and transplantation over the net decade is

predicted to eceed 94 D" trillion. he economic burden could strain health care budgets

in developed countries. Replacement therapy is epensive worldwide but it is too costly

for vast ma6ority of /epalese. /epal belongs to one of the least developed (-*C) where

per capital is much less than the cost of dialysis therapy alone. For lower income

countries it is impossible to meet such costs (*ulal, %&&7).

1ssuming on prior knowledge of patient care, nursing procedures, or dialysis principles,

it takes an overview of disciplinary approach to provide an overview of dialysis

technology and the relationship of dialysis to nursing, nutrition medicine, and

psychological aspect of treatment (fileA??GAEriviewof hema.htm).

5t is very much essential to eplore the knowledge of nurse regarding care of patients

undergoing hemodialysis as nephrology nurses play an important role in providing high

uality care.

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1.' S!gn!f!cance of the Stud

". he finding of the study will help for further study as baseline study.

2. he finding of the study helps or guides the hospital for the development of

educational programme for their staff to increase knowledge regarding care of

patients undergoing hemodialysis.

1.( O&)ect!*e# of the Stud

1.(.1 +enera" O&)ect!*e#

o assess the knowledge of nurses regarding care of patients undergoing

hemodialysis.

1.(.,Sec!f!c O&)ect!*e#

o find out socio:demographic data of nurses.

o find out the knowledge of nurse regarding pre hemodialysis care.

o find out the knowledge of nurse regarding intra hem dialysis care.

o find out the knowledge of nurse regarding post hem dialysis care.

1. Re#earch /ue#t!on

hat level of knowledge do the nurses have regarding care of patients

undergoing haemodialysis

1.0 ar!a&"e# under Stud

Deendent ar!a&"e# >nowledge of nurses regarding care of patients (pre, intra and post)

undergoing haemodialysis.

Indeendent ar!a&"e#

ork 3perience

raining

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3posure to hemodialysis unit

5n:service education on hemodialysis

1.2 Oerat!ona" Def!n!t!on>nowledgeA : >nowledge means information, awareness, understanding and cognitive

ability regarding pre, intra and post haemodialysis care.

/urseA : 5t includes the nurses who are working in /'C (5C9, medical, surgical,

paediatric hemodialysis, 0. etc) and who have completed 1./.'. @C- or / in

nursing.

@atientsA : Clients who are ill and need for haemodialysis.

@re haemodialysis careA:Care provided by the nurse to the client before haemodialysis

that includes diet, vital signs, fluid, eercise, complications, etc.

5ntra haemodialysis CareA : Care provided by the nurse to the client during haemodialysis

that includes investigations, medicines, vital signs, diet, fluid etc.

@ost haemodialysis careA : Care provided by the nurse to the client after hemodialysis that

includes diet, fluid, medicines, eercise etc.

;emodialysisA : he process of removing metabolic toic substances from the blood

when the kidneys are unable to do so.

1.3 4!%!tat!on# of the #tud

he study is held only in /epal 'edical College due to time limitation.

he duration of time for study limited up to + wks and only =& samples taken.

0nly knowledge of nurses (working in /'C) regarding care of patients

undergoing hemodialysis included.

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CHAPTER-II

REIE5 O6 RE4ATED 4ITERATURE

Chronic renal failure, or 34R*, is a progressive, irreversible deterioration in renal

function in which the bodys ability to maintain metabolic and fluid and electrolyte

balance fails, resulting in uremia or a


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guidelines as practiceH however, it is unclear if clinical nephrology nurses and nephrology

nurse practioners are aware of and accept these guidelines. 5n their article, Rabetoy and

air acknowledge more education is needed for nurses regarding the availability and

application of the guidelines for assisting with patient care and difficult ethical situations.

/ephrologists do seek input from nurses when dealing with types of clinical situations. 5f

the nephrology nurses are not familiar with guidelines, they may have limited influence

on patient outcomes, may not be able to fulfill their roles as patient advocates and may

not be involved in patient decision making. hey recommend nephrology nurses increase

their awareness, knowledge, and comfort level with difficult, ethical patient care

decisions (Christy @rice et al, %&&7).

4aeed 'G 1l:Ghamdi, %&&I conducted a research report on /urses >nowledge and@ractice in ;emodialysis unitsA comparison between nurses in units with high and low

prevalence of hepatitis C virus infection. 1ccording to him, hepatitis C virus (;CK)

infection constitutes a ma6or health issue in many hemodialysis (;*) 9nits all over the

world, including 4audi 1rabia. his study has been conducted in a uestionnaire format

to investigate the nurses knowledge about ;CK and their practice inside the ;* units.

4tructured uestionnaires were distributed among 8+ nurses in units with high prevalence

for ;CK(Group 5) and 8I nurses in units with low prevalence (Group 55).Comparison

was made between the two groups. 5n both groups, =I &f nurses received their ;CK

education by nurse educator, "8 by physicians, "& by both and %8 had no targeted

education. here is no statistical difference in the providers of education between the two

groups. 'ost nurses in both groups isolate patients on the line of ;CK serostatus. he

difference was observed in the method isolation and the use of dedicated machines.%=

nurses (+#) of group 5 practice ward isolation while "+ nurses (I7) of group 55 use

this practice(@L.&I).%=(+#) of group 5 reported using ;CK dedicated machines in

comparison to only seven nurses (%&.=) of group 55 (@L.oo").1ll nurses in group 55

cleaned the machine surfaces and ;* tables after each patient, while only =$ of nurses

in group 5 did so after each patient,8# at the end of the day and three percent never

cleaned the surfaces (@M.&&").he number of dialysis patients cared for by a single nurse

at a time in group 5 was 8.I while in group 55, 5t was ".7 (@M.&&").5n conclusion, ;CK

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infection in high prevalence units is probably related to poor application of standard

health precautions and that isolation does not prevent spread of the disease inside ;*

units. he Centre for *isease Control (C*C) has recommended a training and education

program for ;* personnel before they begin working in the units (Ghamdi, %&&I).

*r.@.> Chhetri et al, "### conducted a research report on eperience of hemodialysis in

ir ;ospital. Four hundred and five patients were taken and managed by ;* over a

period of # years .0ut of I&= patients, %77 were suffering from 34RF and "%$ from 1RF.

Common causes of 34RF in the descending order were diabetic nephropathy,

glomerulonephritis and obstructive uropathy. 'a6ority of patients were initially managed

by intermittent peritoneal dialysis. 1lmost all patients with 1RF recovered from their

diseases after repeated sessions of ;* whereas the result of 34RF population wasvariable. Cumulative " year and I year patient survival were #= and =& respectively

(Chhetri et al, "###).

'ac>en


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*r.@> Chhetri et al, %& conducted a research report on evaluation of dialysis adeuacy

in patients under hemodialysis and effectiveness of dialysers reuses. +o patients were

taken out of which I& were males. otal of "$+ sessions of dialysis were included.

*ialysers were reused for mamimum of # times. 'ean pre urea and post urea were

"+&N =".% mg?d- and 7".$N%$.= mg?d- respectively. -ikewise mean sp>t?v and 9RR

were &.#=N&.%$ and =I.$%N"".%I respectively. 0nly in 8" sessions ("7.&) of "$+

sessions sp>t?v was O".%.'ean pre urea, mean post urea and mean sp>t?v of individual

use of dialysers. here were no reported incidences of febrile reactions and other

untoward side effects related to the reuse of dialysers (Chhetri et al, %&).

*r.*/ 'anandhar et al, %& conducted a research report on vascular access for

hemodialysis in /epal 'edical College and eaching ;ospital. here were all together$% patients.== males (+7.&) and %7 females (88.&).the indication for ;* was C>* =

in 7I (#&.&) and 1RF in $ ("&.&) cases. emporary venous catheter was placed for

initiation of ;* in 7+ patients (#8.&).1K fistula was used to start dialysis in only +

patients (7.&). emporary vascular access in the form of repeated femoral vein puncture

was performed in =I patients (++.&), subclavian vein puncture in "$ patients (%%.&) and

internal 6ugular vein puncture in I patients (=.&). 4ity five (7#.&) patients with first

temporary vascular access had no complications. /ine ("".&) patients had fever and 8

(I.&) patients had poor flow through the catheter. 'alposition, infection, thrombosis,

aneurysm and self removal of catheter were other complications observed. 1verage

puncture of femoral vein as a first vascular access was %.I times. 4ubclavian and internal

6ugular catheters were used as first vascular access for 7 and 7.= times respectively

('anandhar et al, %&).

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CHAPTER-III

8. RESEARCH 7ETHODO4O+8

8." Research *esign

1 simple descriptive method was used to find out the knowledge of nurse

regarding care of patients undergoing haemodialysis.

8.% 4tudy 1rea

he study area was /'C, !orpati.

8.8 4tudy @opulation

@opulation of this study was nursing staff working in /'C, !orpati.

8.I 4ample si


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Close ended uestionnaire was developed.

Formal permission was taken from concerned authority.

8."" *ata 1nalysis

he collected data were arranged, tabulated in the computer and presented

in the form of tables, pie chart, simple bar diagram, multiple bar diagram

as well as graphical presentation.

3.12 5nclusion Criteria

/urses working in /epal 'edical College, !orpati.

/urses who had completed (1/', @C- nursing and ./ nursing).

/urses who were mentally and physically healthy.

/urses who were willing to participate in the study.

3.13 3clusive Criteria

hose nurses who refused to participate in my research activities.

3cept nurses, other people were ecluded.

8."I 3thical Consideration3thical norms were considered. @recautions were taken for the right and warfare of the respondents.

@ermission was taken from the matron of /'C.

Kerbal, informal consent was taken from each respondent.

he privacy, confidentiality and anonymity of the respondents were

maintained throughout the research and thereafter. 1ll the collected information was used only for study purpose.

8."= udget

8."+. ime 4chedule

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CHAPTER 9I

ANA48SIS AND INTERPRETATION O6 DATA

Collected information is meaningless without detailed analysis and interpretation.

Core data are only raw material as for industries and we can use these raw

materials offers refining into real ob6ect like in the industries. 1nalysis and

interpretation of data is an important process in every research .5n this chapter

different information are organi


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/'/0thers(1./.', ;.1, C.'.1, . ed )

"PP

%

I ork eperienceA-ess than % yrs.

%:I yrs.I:$ yrs.'ore than $ yrs.

#

%+$7

"$

=%"+"I

= orking wardA5C9?@0'edical ward4urgical ward;aemodialysis unit0thers(0, 3R, 0rtho, @aed,Gynae?0bs)

"I#I8%&

%$"$$+I&

+ 1ny special training related to

haemodialysisQes/o5f yes, duration+ month"% month'ore than " year

$I%

+%P

"+$%

7=%=

7 ork eperiences in specific wardA(5C9, 0., 'edical, 4urgical,;aemodialysis )Qes

/o5f yes, duration-ess than " year":8 years8:= years'ore than = years

88"7

"8"%7"

++8I

8#.8#8+.8+%".%"8.&8

he above table shows that ma6ority 8"(+%) of respondents are %":%= years,

whereas "(%) are"=:%& years, "&(%&) are %+:8& years, +("%) are 8":8= years

and %(I) are above 8= years. Regarding marital status, married and unmarriedboth group are %=(=&).Regarding educational status, the ma6ority I#(#$) of

respondents are @C- and "(%) of respondent is /. Regarding work

eperience, the highest %+(=%) of respondents are %:I years, remaining #("$)

of respondents are less than % years,$("+) of respondents are I:$ years,7("I)of

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respondents are more than $ years. he highest %&(I&) of respondents are

working in other ward, "I(%$) of respondents are working in 5C9?@0, #("$)

of respondents are working in medical ward, I($) of respondents are working in

surgical ward, 8(+) of respondents are working in hemodialysis unit. hema6ority I%($%) respondents are not taking special training related to

hemodialysis, $("+) of respondents are taking training. 1mong them +(7=)

respondents have + months training eperience and %(%=) respondents have "%

months training eperience. "8(8#.8#) respondents have less than one year work

eperience whereas "%(8+.8+) respondents have ":8 years work eperience.

4imilarly, 7(%".%") respondents have 8:= years work eperience and "(8.&8)

respondents have more than = years work eperience.

Ta&"e $

Re#ondent#: ;no


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1mong =& respondents, I"($%) of respondents have the knowledge of best long

term vascular access whereas "#(8$) of respondents are unaware of it, I#(#$)

respondents observe thrill and bruit in patients having 1K fistula on hand.

Remaining "(%) of respondent are found lack of knowledge, %$(=+) ofrespondents advise not to ambulate or sit in upright position if the femoral catheter

is in situ whereas %%(II) of respondents dont advise, =&("&&) of respondents

know the reasons to use fistula for drawing blood, %+(=%) of respondents use to

watch for concealed hemorrhage when fistula is punctured whereas %I(I$) of

respondents are unknown of it.

Ta&"e '

6"u!d and !t# 7ea#ure%ent !n ;!dne D!#ea#e

SN De#cr!t!on 6re=uenc Percentage

" /ecessary to measure%I hour urine output in

kidney disease

I7 #I

% Fluid given in %I hour

should be eual to

urinary output

"# 8$

1mong =& respondents, I7(#I) of respondents agree to measure %I hour urine

output in kidney disease and 8(+) of respondents dont agree. 4imilarly, "#(8$)

of respondents know fluid to be given in %I hour is eual to urinary output

whereas 8"(+%) respondents are unknown of it.

Ta&"e ,

;no


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SN De#cr!t!on 6re=uenc Percentage" ;emodialysis is a

process of removingmetabolic toicsubstance from blood.

I# #$

% 4tandard hemodialysiscan be performed 8times per week, for I: =hour.

"= 8&

8 5nvestigations thatshould be done beforefirst session of hemodialysis aresodium, potassium,urea, creatinine, C,*C, 34R, ;b, ;5K,;s1G.

8% +I

I 'edicine withholdbefore on the day ofhemodialysis isantihypertensive.

%8 I+

= 5n diabetic patient,make sure he gets hisinsulin and breakfastbefore hemodialysis.

8I +$

+ ;eparin is given toprevent blood clottingduring hemodialysis

=& "&&

7 Kital signs should betaken freuently inunstable patients duringhemodialysis.

"I %$

he ma6ority I#(#$) of respondents define the term hemodialysis whereas

"(%) respondent is unknown about it,"=(8&) of respondents have the

knowledge of standard hemodialysis that can be performed 8 times per week, for

I:= hour whereas ma6ority 8=(7&) of respondents are unaware of it, 8%(+I) of

respondents know the investigations to be done before " stsession of hemodialysis

whereas "$(8+) of respondents are found lack of knowledge, %8(I+) of

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respondents withhold antihypertensive medicine before on the day of hemodialysis

but %7(=I) of respondents are found lack of knowledge. 4imilarly, 8I(+$) of

respondents have the knowledge that diabetic patients should get insulin and

breakfast before hemodialysis, =&("&&) of respondents use to give heparin toprevent blood clotting and "I(%$) of respondents use to record vital signs

freuently in unstable patients.

Ta&"e (

Nur#!ng Re#on#!&!"!t!e# Regard!ng Pat!ent# Care

SN Nur#!ng re#on#!&!"!t!e#

dur!ng he%od!a"#!#

6re=uenc Percentage

" o measure height and weight,watch the fistula site.

II $$

% o apply pressure withsand bag for appro. "hour after removingfemoral catheter.

8+ 7%

8 o give health educationabout diet and fluidrestriction.

I8 $+

I o inform the doctor aspatient may need re:dialysis if the predialsisweight is not reducedafter dialysis.

%$ =+

= 5nfection can beprevented by washingthe dialyser during thehemodialysis.

%# =$

'a6ority II($$) of respondents use to measure height, weight and watch the

fistula site during hemodialysis whereas +("%) of respondents are found not to

measure height, weight and fistula site. 'a6ority 8+(7%) of respondents use to

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apply pressure with sand bag for approimately " hour after removing femoral

catheter whereas "I(%$) of respondents are found not to do so.I8($+) of

respondents use to give health education about diet and fluid restriction to the

patient during discharge whereas 7("I) of respondents are found lack ofknowledge,%$(=+) respondents used to inform the doctor as patient may need re:

dialysis if the pre:dialysis weight is not reduced after dialysis whereas %%(II) of

respondents dont inform the doctor. 0ut of =& respondents, %#(=$) of

respondents have the knowledge that infection can be prevented by washing the

dialyser whereas %"(I%) of respondents are unknown of it.

6!gure 1Effect!*e Treat%ent for Cra%#

1bove figure shows that ma6ority, 87(7I) of respondents use hypertonic saline

or detrose solution f or effective treatment for cramps whereas "%(%I) of

respondents use local cold application and "(%) of respondent use oygen

inhalation.

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6!gure ,

Chron!c Co%"!cat!on of He%od!a"#!#

1bove figure presents that "I(%$) of respondents know that hepatitis C virus

infection is the chronic complication of hemodialysis whereas "+(8%) of

respondents reply itching, "&(%&) respondents reply hypotension and chest pain

respectively.

CHAPTER-

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SU77AR8 O6 6INDIN+S> DISCUSSION> CONC4USION AND

RECO77ENDATION

(.1 Su%%ar of 6!nd!ng#'a6ority 8"(+%) of respondents were age group of %":%= years.

'arried and unmarried were eual in number.

'a6ority I#(#$) of respondents were @C- level.

0ut of =& respondents, %+(=%) of respondents had %:I years work eperience.

'a6ority I%($%) of respondents were not taking special training related to hemodialysis.

'a6ority 88(++) of respondents were working in specific ward.

'a6ority %&(I&) of respondents knew the correct answer of symptoms of chronic renaldisease.

0ut of =& respondents, I#(#$) of respondents defined the term hemodialysis .

'a6ority 8=(7&) of respondents didnt know the time interval of standard hemodialysis

that can be performed.8 times per week for I:= hours.

'a6ority 8%(+I) of respondents had the knowledge about the investigation that should

be done before first session of hemodialysis .

'a6ority I7(#I) of respondents knew that it is necessary to measure%I hour urine

output in kidney disease.

0ut of =& respondents, "#(8$) of respondents used to give fluid eual to urinary output

in %I hour.

'a6ority I"($%) of respondents considered the best long term:term vascular access as

1K fistula.

'a6ority I#(#$) of respondents observed thrill and bruit in patients having 1K fistula

on hand.

0ut of =& respondents, %8(I+) of respondents had the knowledge to withhold medicine

before hemodialysis.

0ut of =& respondents, %$(=+) of respondents advised not to ambulate or sit in upright

position if the femoral is in situ.

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'a6ority 87(7I) of respondents told the effective treatment for cramps as hypertonic

saline or detrose solution.

'a6ority 8I(+$) of respondents knew the action to be done in diabetic patient before

hemodialysis.

1ll =&("&&) of respondents used to give heparin during hemodialysis.

0ut of =& respondents "I(%$) respondents used to vital signs during hemodialysis.

'a6ority II($$) of respondents answered the nursing responsibilities during

hemodialysis .

'a6ority %#(=$) of respondents wash the dialyser to prevent infection during

hemodialysis.

0ut of =& respondents, "I (%$) of respondents had the knowledge of chronic

complication of hemodialysis .

'a6ority 8+(7%) of respondents used to apply pressure with sand bag for

approimately " hour.

1ll =& ("&&) of respondents knew that fistula should be used for dialysis.

'a6ority %+(=%) of respondents used to watch for concealed hemorrhage when fistula

is punctured.

'a6ority I8($+) of respondents used to eplain diet and fluid restriction to the patient

during discharge.

'a6ority %$(=+) of respondents used to inform the doctor as patient may need re:

dialysis if the pre:dialysis weight is not removed.

(., D!#cu##!on

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5n my research, more respondents are found having more knowledge on care of

hemodialysis patients which is similar to the findings of G.-. 'oore and Renal

@hysicians 1ssociation (R@1) and the 1merican 4ociety of /ephrology

(14/).1ccording to them, more education, knowledge and guidelines are necessary to

provide hemodialysis care.

'a6ority 8%(+I) of respondents had the knowledge about the investigation that should

be done before first session of hemodialysis ,ma6ority I7(#I) of respondents knew that

it is necessary to measure%I hour urine output in kidney disease,ma6ority 87(7I) of

respondents told the effective treatment for cramps as hypertonic saline or detrose

solution,ma6ority 8I(+$) of respondents knew the action to be done in diabetic patient

before hemodialysis,all =&("&&) of respondents used to give heparin during

hemodialysis,all =& ("&&) of respondents knew that fistula should be used for dialysis,

ma6ority %+(=%) of respondents used to watch for concealed hemorrhage when fistula is

punctured, ma6ority I8($+) of respondents used to eplain diet and fluid restriction to

the patient during discharge.5t is true because all the respondents of this research are

working in >athmandu valley where more advance technology is used and specialist

doctors work . 5t is also true that nursing personnel should have adeuate knowledge to

provide uality care to the patients.

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(.$ Conc"u#!on

Research on any sub6ect is knowledge itself but a challenging process. 1fter completion

of this study, the researcher concludes that study on the hemodialysis care s a most

sensitive and challenging due to its broad scope.

1ccording to the findings of this study the researcher conclusions are given belowA

0nly @C- level knowledge is not sufficient to provide better hemodialysis care.

'ore working eperience plays a vital role in providing skilled hemodialysis care.

raining and in:service education are important part in nursing service. 9ntrained

personnel cant maintain up to date knowledge and cant provide uality care.

4trict sterile techniue should be followed in hemodialysis unit.

*ischarge teaching about diet, medication, and fluid is another important aspect of

hemodialysis nurse.

@roper communication and information system play vital role in care of hemodialysis

patients.

(.' Reco%%endat!on for 6urther Re#earch

his study was only limited in /'C with limited time frame. 4o, further

large scale studies could be conducted covering more large areas and nursesincluding their attitude and skills regarding hemodialysis.

Further studies should be done focusing on clients aspects and on the

awareness regarding kidney diseases and hemodialysis in community setting also.

(.( Reco%%endat!on for Co""ege

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Complete education on research sub6ect should provide on time before starting

research work.

here should be adeuate time for proposal writing and it must be finali


26/37


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:httpA??www.enotes.com?nursing:encyclopedia?hemodialysis:shunt:graft:fistula:

care

:httpA??www.uptodate.com?patients?content?topic.do

:httpA??www.drugs.com?enc?kidney:diet:dialysis:patient:html

APPENDI?-I

5OR; P4AN

he research process was proceeding according to plan as shown belowA

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S.N. Ta#k to &e

Perfor%ed

Re#on#!&"e

Per#on

5eek

1#t ,nd $rd 'th (th th1 opic

4election

5ndividual

researcher

, opic

presentation

5ndividual

researcher

$ -iterature

review

5ndividual

researcher

' @roposal

writing and

presentation

5ndividual

researcher

( @re: testing 5ndividual

researcher

*ata

collection

5ndividual

researcher

0 *ata

analysis

5ndividual

researcher

2 Report

writing

5ndividual

researcher

3 Reportpresentation

5ndividualresearcher

1@ Report

4ubmission

5ndividual

researcher

APPENDI? 9 II

BUDE+ETAR8 P4AN

S.N. Budget Breakdo


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III. Stat!onar Co#t". Files % pcs Rs 8?pcs Rs. +?:

%. al pens 8 pcs Rs. "=?pcs Rs. I=?:

8. @encil " pcs. Rs. =?pcs Rs.=?:

I. @hotocopy papers " packet Rs. %7& Rs. 8=&?:

=. ransparency papers = pcs. Rs.= Rs. %=?:+. @hotocopy 8&& pages Rs %?page Rs. +&&?:

7. @rint out Cost %=& pages Rs.

=?page

Rs. "%=&?:

$. 4piral binding I Rs. %= Rs. "&&?:

5K ravel Cost (for "I days data collection

)

1s well as to meet 1dvisor

"I day Rs. I&?day

"= days Rs. %=?day

Rs. =+&?:

Rs. 87=?:

K. Report riting (typing) =& pages Rs.

"=?page

Rs. 7=&?:

K5. 5nternet charge =&hour Rs. %&?hour Rs. "&&&?:

K55. @hone call charge 8& call Rs. 8?call Rs. #&?:

TOTA4 R#. 1(#-

APPENDI? 9 III

NEPA4 INSTITUTE O6 HEA4TH SCIENCES(1ffiliated to @urbanchal 9niversity)

oudha, usal

Research 2uestionnaire

*ateA:

To!c>nowledge of nurses regarding care of patients undergoing hemodialysis.

O&)ect!*e# o assess the knowledge of nurses regarding care of patients undergoinghemodialysis.

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In#truct!on#

i. he obtained information will be used only for the study purpose.ii. 5t will be kept confidential.

Part IDe%ograh!c DataA

T!ck the correct one 1. Age

a) "=:%& yrs. ( )

b) %":%= yrs. ( )

c) %+:8& yrs. ( )

d) 8":8= yrs. ( )

e) above 8= yrs. ( )

,. 7ar!ta" Statu#

a) married ( )

b) unmarried ( )

c) separated ( )

d) divorced ( )

e) committed ( )

$. Profe##!ona" educat!ona" #tatu#

a) @C- (@roficiency Certificate -evel) ( )

b) / (achelor in /ursing) ( )

c) '/ ('aster in /ursing) ( )

d) others (1./.'., ;.1., C.'.1., . 3d) ( )

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a) less than % yrs. ( )

b) %:I yrs. ( )

c) I:$ yrs. ( )

d) more than $ yrs. ( )

(. Pre#ent" Surg!ca"> He%od!a"#!# a) yes ( )

b) no ( )

5f yes, durationA

a) less than " yr. ( )

b) ":8 yrs. ( )

c) 8:= yrs. ( )

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d) more than = yrs. ( )

Part II/ue#t!on# re"ated to d!#ea#e care re> !ntra o#t

T!ck the correct one

1. He%od!a"#!# !#

a) a process ( )

b) a chemical process ( )

c) a chemical N mechanical process ( )

d) a process of removing metabolic toic substance from blood ( )

,. Ho< often #tandard he%od!a"#!# can &e erfor%ed er


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b) no ( )

c) dont know ( )

(. Ho< %uch f"u!d do ou g!*e !n ,' hourGa) %I hr. urinary output of previous day N =&&ml ( )

b) eual to urinary output ( )

c) "=&& ml ( )

d) S glass of water in every thirst ( )

. 5h!ch one !# con#!dered the &e#t "ong-ter% *a#cu"ar acce##G

a) av graft ( )

b) av fistula ( )

c) a venous catheter ( )

d) dont know ( )

0. 5hat #hou"d ou oer*e !n at!ent ha*!ng A f!#tu"a on handG

a) pulse ( )

b) thrill and bruit ( )

c) both ( )

d) dont know ( )

2. 5h!ch %ed!c!ne do ou

a) hypoglycemic agent ( )

b) antidiabetic ( )

c) antidiuretic ( )

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d) antihypertensive ( )

3. If fe%ora" catheter !# !n #!tu> then *!ta" #!gn# #hou"d &e taken

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a) every "= min. in stable patient ( )

b) freuently in unstable patient ( )

c) " hourly ( )

d) ".= hourly

1'. N#g. re#on#!&!"!t!e# dur!ng he%od!a"#!# are.

a) measure height and weight ( )

b) watch the fistula site ( )

c) assess fluid status ( )

d) both ( b) and ( c) ( )1(. Dur!ng he%od!a"#!# !nfect!on can &e re*ent &

a) monitor vital signs in between ( )

b) appropriate antibiotic ( )

c) wash the dialyser ( )

d) watch the fistula site ( )

1. Chron!c co%"!cat!on of he%od!a"#!# !#

a) chest pain ( )

b) itching ( )

c) hypotension ( )

d) hepatitis C virus infection ( )

10. Nur#!ng re#on#!&!"!t after re%o*!ng fe%ora" catheter !# to

a) in6ect 3@0 ( )

b) in6ect vitamin > ( )

c) apply pressure with sand bag for approimately " hour ( )

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Documents

PATIENTS UNDERGOING HEMODIALYSIS