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학습 자료 둘러보기 →The clinical diagnosis of uremic syndrome with critically elevated BUN > 150-200 mg/dL and creatinine > 8 mg/dL is a definitive indication for immediate hemodialysis. This represents a life-threatening state where the accumulation of nitrogenous waste products causes systemic toxicity, and the body's compensatory mechanisms have failed.
Priority nursing intervention is to prepare the patient for dialysis. This includes ensuring vascular access, stabilizing vital signs, and withholding medications that are removed by dialysis. Delaying renal replacement therapy in the presence of overt uremic symptoms can lead to irreversible complications such as uremic encephalopathy, pericarditis, and bleeding diathesis.
Do not administer diuretics or encourage increased fluid intake in end-stage renal disease. Diuretics are ineffective, and fluid loading in an anuric or oliguric patient risks pulmonary edema. A high-protein diet is contraindicated as it exacerbates azotemia.
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