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FDAR - Salimbagat - Hemodialysis

The document summarizes the care provided to a 65-year-old male hemodialysis patient experiencing itching. At 8:00 AM, the patient complained of persistent itching 30 minutes after starting dialysis treatment. The nurse assessed for potential causes of pruritus, applied moisturizer, and educated the patient on preventing scratching and applying emollients. By 8:10 AM, additional interventions were taken including changing dialysate, flushing with normal saline, and correcting calcium and phosphorus levels. The patient reported an absence of itchiness and comfort by 8:30 AM, indicating the goal of relieving pruritus was met.

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Christine Pialan Salimbagat
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348 views2 pages

FDAR - Salimbagat - Hemodialysis

The document summarizes the care provided to a 65-year-old male hemodialysis patient experiencing itching. At 8:00 AM, the patient complained of persistent itching 30 minutes after starting dialysis treatment. The nurse assessed for potential causes of pruritus, applied moisturizer, and educated the patient on preventing scratching and applying emollients. By 8:10 AM, additional interventions were taken including changing dialysate, flushing with normal saline, and correcting calcium and phosphorus levels. The patient reported an absence of itchiness and comfort by 8:30 AM, indicating the goal of relieving pruritus was met.

Uploaded by

Christine Pialan Salimbagat
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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FDAR CHARTING

(Focus-Data-Action-Response)

Age: 65 y.o Sex: Male CC: Itching during hemodialysis

Medical Diagnosis: Not indicated

Date, Time, and FOCUS PROGRESS NOTES


Shift

03/14/2022

7am-3pm

8:00 AM Itching D- Male patient received in a sitting position with


arteriovenous (AV) fistula access placed on his upper right
arm. Patient appears tired but is coherent, drowsy, oriented
to self, time, place, and events, vital signs as follows: BP
120/70 mmHg, oral temperature: 37 degree C, HR 85 bpm,
RR 22 breaths/minute, dry and pale mucous membranes
and dry skin noted. Patient complained of persistent and
recurrent bilateral discontinuous itch 30 minutes after the
start of hemodialysis treatment as well as dryness of his
skin. Patient stated being uncomfortable and has the urge
to scratch his skin aggressively. -------------------------------
CPS

A- Assessed patient if the pruritus is localized or


generalized, assessed the duration of pruritus, character of
pruritus (paroxysmal or continuous), exacerbating and
relieving factors, detailed drug history, and treatments he
tried such as prescription/over the counter, topical, oral etc.
8:10 AM Assessed dialysis adequacy, considered heparin allergy,
and patient switched to NS flush as indicated, considered
changing dialyzer, tubing, dialysate (to ultra-pure dialysate
fluid). Corrected serum phosphorus and calcium levels.
Advised the patient not to rub or scratch the itchy areas.
Applied aggressive skin moisturization with topical
emollients such as fragrance-free Pramoxine 1% in
emollient. Conducted patient education on importance of
avoiding or minimizing scratching of itchy areas, as well
as application of emollients and natural oils, such as baby
oil, Menthol 0.25%/camphor 0.25% in emollient twice a
day or thrice a day and especially after bathing as ordered
by the physician. Acupuncture, UVB phototherapy, and
Opioid receptor modulator can also be considered as
indicated.
----------------------------------------------------------------------
CPS

R- (Goal Met) Patient stated comfortability and absence of


itchiness all over his body---------------------------------- CPS

Patient’s Name / Room No. | 1


CPS, SN

MSU-IIT CON

8:30 AM

Patient’s Name / Room No. | 2

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