A client has been missing some scheduled hemodialysis sessions. Which intervention is most important for the nurse to implement?
a. Discussing with the client his or her ac-ceptance of the disease
b. Discussing with the client the option of peritoneal dialysis
c. Rescheduling the sessions to another day or another time
d. Stressing to the client the importance of going to the sessions
A
Some people on dialysis retreat into complete or partial denial of the disease and the need for treatment. They may deny the need for dialysis and/or may not adhere to drug therapy and diet restrictions. Providing support as the client struggles to accept the disease is an important step in ensuring compliance with the dialysis regimen. The nurse should explore scheduling options, but missing so many sessions cues the nurse that a bigger problem than just scheduling is involved. The nurse should provide education, but simply stressing the need for dialysis will not help the client accept it. Peritoneal dialysis, with its technical demands on the client and partner, probably is not an option for a client who appears noncompliant with hemodialysis.
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