Diabetic nephropathy is a common and serious complication of diabetes, diabetic microangiopathy, characteristics of diabetic nephropathy in elderly patients: age, long course of disease, comorbidity, years without any obvious symptoms, with the progression of the disease appeared proteinuria, hypertension, renal dysfunction and a series of clinical manifestations in our department from December 1998 to January 2003 there were 212 cases of senile diabetes mellitus, nursing will now be described as follows.
1 clinical data
This group of 212 cases, all accord with the diagnostic criteria of type 2 diabetes. There were 202 males and 10 females, aged from 60 to 84 years old. The clinical diagnosis of 212 cases of senile diabetes mellitus, including 51 cases of diabetic nephropathy, accounted for 24%, with clinical proteinuria, in 17 cases of diabetes with high blood pressure, 5 patients died, one died of uremia in 2 cases, accounting for
2 nursing experience
2, 1 blood glucose control according to the doctor's good glycemic control, because hyperglycemia is considered to cause kidney disease only because of the strict control of blood glucose, can delay the progress of renal disease effects in preclinical, maintain normal blood glucose, can cause kidney function, we observed a positive correlation between blood glucose concentration and the amount of urine protein, the need to observe after treatment of the reaction, such as: the change of blood glucose, carefully glycosylated serum protein index, urine sugar, urine ketone, renal function change etc.. Guide elderly patients to strictly implement the diet plan, as far as possible to control blood sugar in 6. Below 5mmol/L.
2, 2 in control of blood pressure in patients with diabetic nephropathy hypertension has an important influence on the progress of renal disease, and strictly control the development of blood pressure can delay diabetic nephropathy, blood pressure should be daily routine monitoring of patients, blood pressure was larger than 150/90mmHg are using antihypertensive drug indications, normal renal function by converting enzyme inhibitor is preferred, kidney hypofunction to plendil calcium antagonist is preferred, careful observation of blood pressure in patients with the use of antihypertensive drugs, report to the doctor at any time to adjust the application of antihypertensive drugs.
2, 3 diabetic nephropathy patients protection of vascular vascular elasticity, vascular thin, brittle and hard for the characteristics of vein puncture gently, sharply, vascular should follow the principle from small to large, from far to near, forearm vein to try to protect, to keep the blood dialysis liquid, especially a important.
2. 4 dialysis treatment of diabetic nephropathy to end-stage renal disease patients with dialysis is the main treatment of end-stage renal disease. In chronic hemodialysis patients and peritoneal dialysis should strengthen nursing, protect vascular fistula, prevent infection and fistula abscission. The peritoneal dialysis patients should be strictly formal operation, strengthen the abdominal skin care, prevent catheter tunnel and peritoneal infection, should strengthen the basic nursing, precise intake and output record, close observation of dialysis, make patients get good treatment.
The characteristics of elderly diabetic nephropathy are old age, long course of disease, comorbidity, in nursing, caring patients, establish a good doctor-patient relationship with trust, reasonable adjustment of diet, give guidance to medical knowledge, dialysis patients psychological guidance, eliminate the emotional tension, is conducive to the normal families with dialysis, so, elderly patients achieve the best psychological state, therefore, in the course of changes in nursing work plays an extremely important role.
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