Patient education in dialysis | Espace Infirmier
 

L'infirmière Magazine n° 385 du 01/09/2017

 

FORMATION ANGLAIS

ÉMILIEN MOHSEN  

PROFESSEUR D’ANGLAIS AUX IFSI DE NANCY ET AUTEUR DE « l’ANGLAIS MÉDICAL PRATIQUE À L’USAGE DES PROFESSIONNELS DE SANTÉ », ÉD. LAMARRE, 2017

A nurse and a patient are discussing peritoneal dialysis, the signs and symptoms, and what triggers an emergency admission, the medication effects and health hygiene.

Nurse: People with damaged kidneys may have ­difficulty eliminating waste from the blood. Dialysis is an artificial way of carrying out this process. It substitutes the natural work of the kidneys, which is to regulate the body’s levels of water and minerals, and remove waste. They also secrete products that are important in metabolism. If they do not work ­properly, waste builds up in the blood. This can lead to coma and death. Dialysis prevents the waste products in the blood from reaching hazardous levels. It can also remove toxins or drugs from the blood in an emergency setting. In your case, we will proceed to peritoneal dialysis.

Patient: What’s that?

Nurse: There are two kinds of dialysis. In hemodialysis, blood is pumped out of your body to an artificial kidney machine, and returned to your body by tubes. In peritoneal dialysis, the inside lining of your own belly acts as a natural filter. Wastes are taken out by means of a cleansing fluid called dialysate, which is washed in and out of your belly in cycles.

Patient: And how does peritoneal dialysis work?

Nurse: A soft plastic tube, called a catheter, is placed in your belly by means of surgery. A sterile cleansing fluid is put into your belly through this catheter. After the filtering process is finished, the fluid leaves your body through the catheter.

Patient: Then I should come to hospital each time I need dialysis, shouldn’t I?

Nurse: In your case, we use the machine-free peritoneal dialysis. You can do this on your own while you go through your normal activities. You place the cleansing fluid into your belly and later drain it. This is done by hooking up a plastic bag of cleansing fluid to the tube in your belly. When empty, it is removed and thrown away. This is done 3 to 5 times in a 24-hour period while you are awake during normal activities. Each exchange takes about 30 to 40 minutes. So, the most important thing here is hand hygiene.

Patient: Are there any symptoms for an emergency dialysis?

Nurse: Yes. It can be high creatinine level, vomiting, nausea, and poor appetite; severe swelling or edema; high potassium level or hyperkalemia; shortness of breath; muscle cramps and muscle acidosis.

Patient: Are drugs prescribed for renal dysfunction?

Nurse: The commonly prescribed drugs include proton pump inhibitors, statins, corticosteroids and calcium channel blockers. But since patients on dialysis might have comorbid pain, analgesics are also prescribed, but also antimicrobials, anticoagulants and even insulin, depending on the case.

Patient: Are there any side effects to these drugs?

Nurse: They are usually hepatic and gastrointestinal.

Patient: Are there any other recommendations?

Nurse: Yes. Health hygiene is a must. You should eat more high protein foods, and avoid high salt, high potassium, and high phosphorus foods. And learn how much fluid you can safely drink. The dietitian will tell you more about all this.

VOCABULAIRE

Dialysis: dialyse

Analgesics: antalgiques

Calcium channel blockers: inhibiteurs de canaux calciques

Gastrointestinal problems: troubles gastro-intestinaux

Renal dysfunction: dysfonction rénale

Swelling: gonflement (œdème)

Muscle acidosis: acidose musculaire

Common phrases

People with damaged kidneys may have difficulty eliminating waste from the blood.

→ Les gens souffrant d’insuffisance rénale peuvent avoir des difficultés à éliminer les déchets de leur sang.

Dialysis substitutes the natural work of the kidneys.

→ Le dialyse se substitue au fonctionnement naturel des reins.

There are two kinds of dialysis, hemodialysis and peritoneal dialysis.

→ Il existe deux types de dialyse, l’hémodialyse et la dialyse péritonéale.

In hemodialysis, the blood is pumped out of your body to an artificial kidney machine, and returned to your body by tubes.

→ L’hémodialyse consiste à envoyer le sang par un petit tuyau vers un rein artificiel, qui le renvoie ensuite dans le corps.

In peritoneal dialysis, wastes are taken out by means of a cleansing fluid called dialysate, which is washed in and out of your belly in cycles.

→ La dialyse péritonéale permet d’éliminer les déchets grâce à une solution appelée dialysat, qui circule dans le ventre.