This article described the nursing process of assisting an ESRD post-surgery patient who had been admitted to hospital due to bladder cancer, but complicated with posterior reversible encephalopathy syndrome (PRES); the nursing period lasted from April 22nd to July 15th, 2009. Information was collected by interview and observation. Two main health problems were identified: fatigue and caregiver role strain, as the result of physical, psychological and social fatigue derived from long hospitalization and social isolation due to acute and chronic diseases. Through caring, accompanying, providing consultation and encouraging ambulation process, the patient not only adapted to the fatigue after surgery, but also regained functional independence. This nursing experience can help nursing staffs to thoroughly understand the reactions of ESRD Patients who are complicated with PRES, as well as providing a basis for an effective enhancement of the home care skills of the caregivers.