Caring for patients with excessive interdialytic weight gain (IWG) and/or hypertension challenges nephrology nurses and other healthcare providers.
He has been experiencing problems with excessive IWG. Although Mr.
Adherence to fluid intake restriction is closely related to better clinical outcomes (Kim & Evangelsta, 2011), and IWG is often used as a reliable indicator to evaluate adherence to fluid intake restrictions (Denhaerynck et al., 2007).
In general, both physiological and psychological aspects need to be evaluated in order to understand patients with large IWG. Patents on maintenance HD often complain of thirst (craving for fluids) and/or xerostomia (dry mouth).
His medical professionals expected his BP to be brought under control by taking anti-hypertensives and keeping an ideal IWG. To monitor medication adherence, the HD unit nurses counted anti-hypertensive pills and educated him about the importance of taking anti-hypertensive medications.
The evaluation of sarcopenia, as proposed by the first definitions and by the EWGSOP and IWGS
consensus, has been performed in research, even with its inherent limitations.
DI also participated in interdepartmental working groups (IWGs
), the most important being IWGs
on the SADC countries, concentrating on conflict areas, crime, especially illegal fire-arms, and undocumented migrants, corruption within the DOD, urban terrorism, provincial security appraisals, information systems security revision and VIP protection and training.
One obvious reason for drinking too much and excessive IWG might be that these patients suffer from thirst as demonstrated by quotes from the literature, such as "...
(b) To what extent is thirst related to IWG? and (c) What interventions are applied to minimize thirst?
Six studies gave information about the relationship between thirst and IWG, and 15 articles reported about some kind of intervention.
(1994), exaggerated thirst was reported by 86% of the patients, while IWG greater than 4% of body weight was found in 34% of patients.