Nursing care of patient with metformin associated lactic acidosis (MALA) received hemodialysis treatment : 2 cases study

Abstract

Abstract

            Lactic acidosis from the use of metformin (Metformin Associated Lactic Acidosis) is a complication with a relatively low incidence. But if it occurs and is severe enough to cause death, critical treatment to correct acidosis with good results is hemodialysis. (Hemodialysis) In order to be successful in treating and correcting acidosis, it must Relying on the ability to diagnose quickly and accurately Preparing the patient for insertion of the tube Double lumen Cather (Double lumen Cather) care during hemodialysis and after hemodialysis. Nurses play a very important role in deciding to care for patients using the nursing process that consists of assessment, nursing diagnosis, planning, nursing action, and evaluation. To keep patients safe and overcome crisis situations.

            Methods : Two specific case-by-case studies were conducted between September and October 2023 in Metformin Associated Lactic Acidosis (MALA) patients receiving hemodialysis treatment Roi Et Hospital

            Results : Both case studies had a history of type 2 diabetes treated with Metformin and also had hypertension. Case 1, a 52-year-old female patient, presented with vomiting 3 times and diarrhea 3 times. Once, no use, lost appetite for 1 hour, more tired and tired, body cold, lethargic, so came to the hospital to receive hemodialysis after receiving treatment for 37 hours, including 2 times of hemodialysis. Case 2, a 68-year-old male patient had symptoms that were not suitable. Due to medication, there were 4 loose bowel movements, vomiting, and later, inability to urinate along with shock. Received urgent hemodialysis 8 hours after admission, including 2 times of hemodialysis. Results of treatment for both patients 2 case from severe acidosis and Acute kidney injury Received care according to nursing procedures until transferred from the medical intensive care unit. The patient was discharged. Total length of hospital stay was 10 days.

            Conclusion : Treatment of Metformin Associated Lactic Acidosis (MALA) patients should receive treatment. By early hemodialysis with an artificial device, it will help remove excess lactic acid and reduce acidosis, helping the patient survive. Therefore, hemodialysis nurses must have knowledge. Expertise in using. The nursing process for providing effective hemodialysis care Helps reduce birth Complications both during and after hemodialysis.

Keywords : Metformin, Lactic Acidosis, Hemodialysis