1、 Daily care of hemodialysis patients:
(I) Daily skin care: 1. Do not apply soap directly to the skin when taking a bath. After taking a bath, wipe lotion. 2. Cutting nails short can avoid scratching the skin and prevent infection. 3. When there is local itching, ice cream or some cooling oil can be applied. 4. If the skin itching is unbearable, please ask the doctor to take medication or topical medication. 5. When itching is severe, pay attention to testing blood calcium, phosphorus, and parathyroid hormone levels to maintain normal levels.
（2） How can dialysis patients relieve emotional stress?
When feeling down or depressed, one can express their inner feelings to alleviate emotional pressure. 2. Psychological and economic assistance can be obtained through social workers. 3. Get to know cases with good rehabilitation, absorb their experience, and increase confidence. 4. Patients with kidney failure usually have sexual dysfunction. If this causes disharmony in daily life or pregnancy problems, they can discuss it with medical staff. 5. Participate in social activities - such as gatherings, outings, or short-term domestic and international trips, accompanied by medical staff. Participating in more tourism can broaden one's horizons, absorb more information, and expand one's social circle.
（3） The principle of exercise for dialysis patients: 1. Any dialysis patient needs to be evaluated by a physician and choose the appropriate exercise method for themselves. 2. Any exercise should be done within one's capacity and should never be forced. 3. Patients with diabetes are often accompanied by postural hypotension and arrhythmia caused by autonomic psychosis. They should be very careful when exercising and pay attention to the changes of blood sugar. They should eat before exercising and carry candy with them to prevent hypoglycemia. 4. Using erythropoietin to increase hemoglobin can improve exercise endurance, but at the same time, it is important to note that serum potassium ions will increase and urea clearance rate will decrease, so it is still necessary to cooperate with a physician.
（4） The nursing focus of daily life for dialysis patients: 1. Regularly receive dialysis treatment. 2. Moderate exercise, adequate rest and sleep. 3. Prevent infection and cultivate good hygiene habits. 4. Measure blood pressure on time and record it. 5. Develop the habit of regular bowel movements and avoid constipation. 6. Soft stool can be used if necessary. 7. Pay attention to diet and water intake. 8. Observe whether there is internal or external bleeding, whether there is swelling or aggravation, the color of urine and feces, and whether there are bleeding spots or bruises on the skin. 9. Keep your body and mind happy. 10. Pay attention to keeping warm; After catching a cold, blood vessels contract and blood pressure rises. Therefore, it is advisable to wear a mask when going out in winter, avoid going barefoot in summer, avoid blowing electric fans for long periods of time, and avoid soaking in cold water for long periods of time. 11. If there is any emergency or discomfort in home life, one should immediately seek medical attention at the outpatient, emergency, or blood purification center or ward.
3、 Dietary precautions for hemodialysis patients:
1. High quality protein: In order to compensate for the loss of protein during dialysis and maintain nitrogen balance, protein intake should be ensured at 1.2g/kg body weight per day, with at least 50% being high-quality animal protein. High quality protein: It contains a large amount of essential amino acids for the human body, making it easier for the body to utilize and synthesize protein, with less metabolic waste. Mainly animal protein, such as fresh milk, eggs, fish, lean meat, etc. Mainly composed of plant protein, such as protein in rice, flour, beans, and vegetables.
2. Adequate calorie intake: Long term hemodialysis patients should have a high calorie diet. Only with sufficient energy intake can the body effectively utilize the protein intake and maintain sufficient nutrient storage. Otherwise, protein in the body will be broken down due to low calorie intake, increasing toxin production; However, excessive heat supplementation can also cause hyperlipidemia, atherosclerosis and other diseases. The calorie intake should be maintained at 35Kcal/kg body weight per day. If there is excessive weight loss or obesity, it should be appropriately increased or decreased. Calories mainly come from carbohydrates and fats, so it is advisable to focus on carbohydrates and grains as much as possible, and eat less fat, especially animal fats.
3. Supplement calcium and vitamins: During dialysis, a large amount of vitamins and trace elements may be lost. Attention should be paid to supplementing calcium, iron, zinc, and B vitamins. Eat more calcium rich foods, but pay attention to limiting phosphorus. For example, when boiling bone soup or stewing pork ribs, boil them in clean water for 3 minutes, discard the water, and then add water to stew, which can remove 1/3 to 1/2 of the phosphorus in the bones. To supplement vitamins, one should eat more fresh fruits and vegetables.
4. Limit the intake of potassium, phosphorus, and sodium: Potassium restriction: Patients undergoing hemodialysis are prone to elevated blood potassium levels, which can lead to severe arrhythmia and even cardiac arrest. The recommended daily intake is generally 2-2.5g. To reduce potassium content in the diet, green leafy vegetables can be soaked for more than half an hour. Root vegetables should be peeled, sliced, soaked in water, and then boiled. Phosphorus restriction: Excessive phosphorus can cause hyperparathyroidism and metabolic bone disease, with a recommended daily intake of 800-1000mg. Sodium restriction: Hemodialysis patients should avoid high salt diets, with a recommended daily salt intake of 3-5g. They should also avoid consuming pickled vegetables, salted eggs, sauces, and various pickled products.
5. Control water intake: Dialysis patients should avoid excessive water intake. The total amount of urine urinated the day before should be increased by 500-700ml, which is the 24-hour water intake, including drinking water, medicine, soup, etc.