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complications/policies and procedures Flashcards

1
Q

Hypotension

-signs and symptoms (6)

A
  • dizziness
  • nausea
  • dehydration
  • lack of concentration
  • blurred vision
  • cold/clammy/pale skin
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2
Q

Hypoglycemia

-signs and symptoms (7)

A
  • sweating
  • tiredness/dizziness
  • feeling hungry
  • tingling lips
  • shaking/trembling
  • high HR/palpitations
  • irritability
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3
Q

Anemia

A

condition in which lacking RBC that carry O2 to body’s tissues

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4
Q

Fluid Overload

A

extra fluid in body

-raises BP and forces heart to work harder

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5
Q

Hypovolemia

A

severe blood/fluid loss resulting into the heart unable to pump enough blood throughout the body

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6
Q

Hyperkalemia

-signs and symptoms

A
  • abdominal pain
  • diarrhea
  • chest pain
  • muscle weakness/numbness
  • nausea and vomiting
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7
Q

Hypokalemia

-signs and symptoms

A
  • muscle twiches
  • muscle cramps
  • paralysis
  • abnormal heart rhythms
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8
Q

Hypovolemia

-signs and symptoms

A
  • hypotension
  • tachycardia
  • increased respiration
  • loss of electrolytes
  • dehydration
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9
Q

Hypovolemia

-potential causes

A
  • dehydration
  • bleeding
  • loss of plasma (burns)
  • excessive diaphoresis
  • DW needs to be assessed
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10
Q

Drop in URR

-signs and symptoms

A
  • progressive weakness
  • fatigue
  • loss of appetite due to nausea and vomiting
  • muscle atrophy
  • tremors
  • abnormal mental function
  • frequent shallow respiration
  • metabolic acidosis
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11
Q

Anemia

-signs and symptoms

A
  • fatigue
  • weakness
  • pale/yellow skin
  • irregular HB
  • angina
  • SOB
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12
Q

Fluid Overload

-signs and symptoms

A
  • high BP
  • SOB
  • edema
  • jugular vein distention
  • irritable/confused
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13
Q

Anemia

-potential causes

A
  • bleeding
  • acute/chronic inflammatory conditions
  • hemolysis
  • vit b12 deficiency
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14
Q

LVH

A

LEFT VENTRICULAR HYPERTROPHY

  • muscular chamber of the heart that accepts blood from left atrium and ejects it into the aorta (to rest of body) that is over worked
  • results to thickening of muscle and decreased ability to pump efficiently
  • diastolic filling is impaired
  • can cause dyspnea, heart failure
  • RBC may become unable to carry O2
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15
Q

CHF

A

CONGESTIVE HEART FAILURE
-unable to deliver adequate supply of oxygenated blood to organs and tissues
-kidney tried to compensate; retention of sodium chloride and water to increase blood volume and venous pressure
+retention of sodium chloride results to dilution of plasma proteins; creates edema
-results to extracellular volume expansion and pulmonary edema

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16
Q

CHF

-signs and symptoms

A
  • excessive fatigue or weakness
  • loss of appetite
  • orthopnea
  • confusion
  • chronic dry cough
  • distended neck veins
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17
Q

Renal Osteodystrophy

-explain

A
  • kidney helps with formation of bone and regulation of calcium-phosphorous balance
  • hypocalcemia or hyperphosphatemia can results to abnormal bone growth

-low calcium/high phosphate signal parathyroid gland to fix the problem; resulting in bone cysts and metastatic calcification

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18
Q

Renal Osteodystrophy

-signs and symptoms

A
  • bone pain
  • fractures
  • muscle weakness
  • bone deformities
  • giant cell granulomas in bone
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19
Q

Common Complications

A
  • hypotension
  • cramps
  • nausea and vomiting
  • headaches
  • chest pain
  • fever and chills
  • cardiac arrest
20
Q

Life Threatening Complications

A
  • arrhythmia, palpitations, chest pain
  • air embolism
  • exsanguination
  • hemolysis
  • hypo/hyperglycemia
  • anaphylactic reaction
21
Q

Hyperglycemia

-signs and symptoms

A
  • fruity-breath
  • nausea and vomiting
  • dyspnea
  • dry mouth
  • weakness
22
Q

Muscle Cramps

-possible causes

A
  • hypotension
  • excessive fluid removal
  • below target weight
  • dialysate sodium level too low
  • fluid and electrolyte balance
  • hypomagnesia
23
Q

Muscle Cramps

-treatment

A
  • stop UF; WLM
  • monitor BP
  • massage area
  • dry weight should be assessed
  • evaluate BV
  • changes to sodium profiling?
24
Q

Arrythmia, palpitations, chest pain

-treatment

A
  • decrease pump to 200; increases intravascular BV
  • WLM; allow shifting of fluid from interstitial space to intravascular space
  • admin O2
  • monitor vitals
  • nitro if no hypotension
  • page nephrologist
  • review blood work: Hgb, K, Ca, Mg
25
Air Embolism
air entering systemic vein travels to right ventricle through vena cava *implodes heart's pumping ability by reducing blood flow to pulmonary circulation
26
Air Embolism | -causes
- CVC insertion/removal - CVC disconnection/loose connection - malfunctioning air detector alarm - air in blood foam, dialyzer, or empty arterial chamber
27
Air Embolism | -signs and symptoms
- dyspnea, cyanosis - chest pain - hypotension, tachycardia - coughing - confusion - seizure, coma, cardiac arrest
28
Air Embolism | -treatment
- stop pump, clamp both lines * NO RETRANSFUSION* - add pressure over CVC removal site - position pt on lft side into trendelenburg for 30 minutes; decreases air going to pulmonary circulation and maintains cardiac output - adult O2 mask at 15L/min; absorbs for nitrogen to help keep alveoli from collapsing - observe vitals; increase in BP and oxygenation indicates air is being cleared - page MD asap
29
Anaphylactic Reaction | -signs and symptoms
- flushing - pruritis - urticaria (hives) - sneezing - watery eyes - cough - abdominal cramps - diarrhea - dyspnea - burning throughout body - chest tightness
30
Anaphylactic Reaction | -causes
- contaminated dialysis solution | - heparin/drug reaction
31
Anaphylactic Reaction | -treatment
- stop blood pump and clamp venous and arterial lines * NO RETRANSFUSION* - admin O2 15L/min - page MD asap - collect blood from both arterial and venous bloodline ports - treat hypotension with saline infusion - collect water and dialysate sample; call techs to check water system - record lot numbers, dialyzer, bloodlines, heparin, acid conc, bicart cartridge - create Safety Point Report
32
Hemolysis | -causes
- hyper/hypo-tonic dialysate - metal oxidants - blood tubing obstruction - temp of dialysate
33
Hemolysis | -signs and symptoms
- chest pain - back pain - dyspnea - translucent blood in venous bloodline - pain at access point - hyperkalemia - drop in Hgb - arrhythmias
34
Hemolysis | -treatment
- stop pump, camp venous and arterial lines * NO RETRANSFUSION; hemolyzed blood = ^ K levels - admin O2 at 15L/min - monitor vitals; treat hypotension if needed - page MD asap
35
Seizures | -causes
- dialysis disequilibrium - electrolyte imbalance - delivery of improperly prepared dialysate - hypotension - reaction to chemical agent - pre-existing seizure disorder
36
Seizures | -treatment
- take blood sample from arterial port to determine seizure activity; low blood sugar, calcium and sodium - retransfuse pt - evaluate blood volume monitoring response - assess DW and sodium profilling - document
37
Blood Leak
caused by defective dialyzer membrane ruptures
38
Large Blood Leak
visible; blood is light pink - clamp venous and arterial * NO RETRANSFUSION* - monitor vitals; look for signs of pyrogenic rx (chills, fever, nausea and vomiting - page MD asap - extreme blood loss results in anemia, chest pain, shock, seizures - pt stable? continue tx with same machine with new line - tell tech asap - after tx bleach and pull aside
39
Small Blood Leak
- using gloves take sample from venous fluid tube, use blood leak strip - retransfuse and change circuit, contrinue with same machine - end of tx, bleach then pull
40
Exsanguination | -causes
- separation of blood lines - venous needle falls out - rupture of vascular access- anastamosis or aneurysm - blood leak
41
Exsanguination | -treatment
- turn pump off, clamp disconnected lines - apply pressure to any bleeding sites - monitor vitals; saline if hypotension - admin O2 if dyspnea - retransfuse unless large blood leak - page MD - draw CBC next treatment to assess need for transfusion
42
Febrile Patient
-draw CBC (check if recent test done, if so check for antibiotic) -draw 2 sets of aerobic and anaerobic (ana first)
43
Hypoglycemia | -treatment
- check BS asap - BS <4 mmol/L; apple juice and glucose tablet - recheck BS 15 min - BS <4 mmol/L; apple juice and glucose tablet - once stabilized give snack package -50mL 50% dextrose IV STAT -glucagon 1mg IM or SC notify MD
44
Hyperglycemia | -treatment
- page MD to require insulin | - insuline may be reassessed
45
Cardiac Arrest | -treatment
- shake and shout - check BP - WLM - position trendelenburg - administer saline - call for help - assess breathing - assess carotid pulse 5-10 seconds - compressions - 5555 CALL CODE BLUE - retransfuse is possible - insert airway bag

dialysis exam (7 decks)

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