CAPD SG- Flashcards by Rain Sanchez

Intraperitoneal medications

sterile injections that can be provided to the patient via the PD catheter.

requires strict aseptic technique

use only sterile medication solutions

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list the most common meds given during PD

Heparin

Antibiotics:

Vancomycin
Gentamycyin
Tobramycyin
Ceftazadine

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What is the role of IP Heparin?

to treat and prevent the formation of fibrin which can impede catheter flow

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Heparin is a ______ molecule and ______ cross the peritoneal membrane.

Heparin is a LARGE molecule and DOES NOT cross the peritoneal membrane.

Heparin only acts within the peritoneal space

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What is the standard heparin dose?

500u or 1000u for every liter of dialysate given

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Does heparin cross the peritoneal membrane?

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When should heparin be avoided?

during frank bleeding

if the patient has a pork allergy

if the patient had recent surgery

if the patient has bleeding disorders

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true or false

You need a doctors order to administer any IP medications?

True

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When should you educate the patient at home to self administer heparin?

during times of poor catheter flow

when fibrin is present in the PD effluent

during episodes of peritonitis to minimize fibrin formation due to WBC accumulation

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When peritonitis is suspected, what should you do BEFORE administering IP antibiotics?

draw cultures and fluid samples

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How long should the antibiotics dwell within the peritoneum?

for a minimum of 6 hours

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What are the six rights of medication administration?

right patient
right medication
right dose
4 right time
right route
right documentation

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Where and when can antibiotics be ordered?

can be ordered through FMCRX during a clinic visit

abx kits can be taken home

you must teach the pt how to administer with aseptic technique and document training

review monthly during med rec. must check expiration, integrity, and review self administration skills

assess for allergies

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true or false

the meds can be mixed ahead of time?

false

must be mixed and immediately exchanged

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What does CAPD stand for?

continuous ambulatory peritoneal dialysis

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What is peritoneal dialysis?

the removal of waste and fluid from the blood using the peritoneal membrane as a filter.

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How long is the fluid left in the peritoneal cavity?

fluid is kept in the abdomen continuously except during drain.

24hours a day / 7 days a week

on rare occasions the peritoneum is left dry

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The CAPD regimen consists of ______ exchanges a day, with the last exchange dwelling for _______ overnight.

4-5

9 hours average

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What are the 3 steps of an exchange and what is the standard time for each one?

drain (20 min)
flush (5 sec)
fill (10-15 min)
dwell (4-5 hours) per prescription

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What is connectology?

how the tubing is secured to the PD catheter in order to complete an exchange

What connectology can be used to do a CAPD echange?

Fresenius stay safe

Fresenius extension tubing

Baxter Ultra Bag

What does SCALE stand for?

Strength
Clarity
Amount
Leakage
Expiration

What is the CAPD exchange process?

Drain
Fill
Dwell

The drain phase takes about 15-20 min depending on the following: (6)

amount of solution
gravity
use of a pump
diameter of tubing
position of pt and intra-abdominal pressure
condition of the system

In which phase does the dialysis take place

dwell

before the fill, flush the system for _____ to remove the air from the tubing and to reduce the amount of air that will travel into the patient. Also shows to reduce the amount of peritonitis in the patients.

5 sec

The fill phase takes about ______ min

10-15

The fill phase is dependent on the following: (4)

1. amount of solution 2. solution bag height 3. diameter of tubing 4. intra-abdominal pressure

the dwell time is _______

prescribed

the dwell time is required for _____ and ______.

transport of solutes across the peritoneum ultrafiltration

The CAPD usual dwell time is :

4-5 hours and 9 average at night

The fluid movement during the exchange process is controlled by

gravity

The following supplies are needed for a CAPD exchange: (12)

1. dialysate solution 2. PPE 3. soap and hand gel 4. IV pole 5. spring scale 6. CAPD flow sheet 7. stay safe organizer 8. organizer holder 9. stay safe cap 10 gauze 11. Alcavis 12. heating pad

When does the initial catheter flush take place?

1 week post insertion wait 2 weeks if possible

If immediate use of the catheter placement is required, what modifications should take place?

decrease fill amount protect catheter from trauma

What is a typical flush volume?

500ml

What is the typical dose for a heparin flush?

1ml or 1000u per liter of dialysate

name 3 things that you should observe the effluent for when flushing?

1. fibrin ( trauma and infection can increase) 2. blood 3. Cloudiness (could be infection or reaction to dialysate)

list the warming PD solutions rules and guidelines (5)

1. promotes patient comfort and diffusion during procedure 2. use a warming pad or other approved warming device (cycler) 3. never microwave 4. never submerge bag or get wet 5. measure temp before exchange and do not administer if over 98.6

list guidelines for PD effluent disposal in home setting for patient care partner

1. care partner must utilize Full PPE 2. dispose of empty effluent bags and lines in double garbage bags or per city and state regulations. 3, document training of proper effluent disposal in the medical record

Full PPE (gown shield mask gloves) is required for RN when performing exchanges?

true

sampling the PD effluent When collecting PD effluent, use ______ to obtain _____ and ________ samples

blood culture bottles aerobic and anaerobic

sampling the PD effluent Use a second set of _______ bottles to collect effluent for _____ testing.

blood culture fungi

Fungi culture take _______ to incubate.

3 weeks

Routine PD fluid cultures take _____ to incubate.

5 days

What is CCPD?

Continuous Cycling Peritoneal Dialysis Form of PD in which the fluid is moved into the peritoneum via a controlled mechanical pump called a cycler. This technology offers automatic delivery of the whole exchange process and provides increased fluid removal.

What is PD Plus?

When all of the exchanges are delivered via the cycler and occur during the night. The machine delivers each exchange with a drain fill and dwell typically lasting 1.5 - 2 hours. The last fill is in the morning and the solution is left for a long daytime dwell An extra exchange during the day is called a PAUSE

NIPD/IPD therapy consists of:

Intermittent Peritoneal dialysis more common during an acute or hospital setting or a skilled nursing facility. During the "dry" period some of the solutes and fluid are reabsorbed back into the bloodstream, Intermittent PD may be more effective for some patients due to the type of membrane they have known as high transporters. frequent exchanges prevent the body from reabsorbing too much fluid during the dwell periods. IP is used on urgent starts as soon as 2 hours post catheter placement

During the _____ period, dialysis is NOT occurring.

DRY