Dialysis

Question 1

With an AV fistula you want to feel the ? and listen to the ?

Answer 1

feel the thrill and listen to the bruit

Question 2

bp / sticks in arm with AV fistula- what ya gonna do?

Answer 2

NOT gonna do it!

Question 3

how long does a it take for an AV fistula to be ready to use?

Answer 3

6 months

Question 4

but like what is an av fistula?

Answer 4

surgocal connection of artery and vein that increases blood flow in that area

Question 5

But how is an AV fistula different than an AV graft- how is the same?

Answer 5

all the same precatuions,
AV Graft. = synthetic material instead of your own arteries/veins connecting

Question 6

how often should you feel for thrill and listen for a bruit on fistula?

Answer 6

every few hours

Question 7

assessments for AV fistula?

Answer 7

-distal pulses
-infection
-thrill/bruit

Question 8

AV fistula complicartions

Answer 8

thrombosis
strictures
infection
ischemia

Question 9

who has greater risk for infection: vas cath or perm cath?

Answer 9

Vas Cath !

vas - nontunneled, short term
perm - tunneled, several months

Question 10

can we use a vas/perm cath for stuff other than dialysis?

Answer 10

only if its an emergency

Question 11

biggest risk for vas/perm cath is —-? what we gonna do about it?

Answer 11

infection!
–>sterile access/dressing changes

Question 12

peritoneal dialysis - why do we like it?

Answer 12

flexible schedule, less dietary restrictions, done at home, managed by patient

Question 13

peritoneal dialysis complications

Answer 13

infection
peritonitis(cloudy effluent)
discomfort
bowel perforation (brown effluent)

Question 14

re: peritoneal diaylsis: signs of peritonitis?

Answer 14

Monitor for cloudy outflow/ effluent **
Abdominal tenderness
Fever

Question 15

what kind of technique do we use when accessing peritoneal dialysis ?

Answer 15

fucking sterile

Question 16

this type of dialysis passes the patient’s blood through artificial semipermeable membrane to filter and excrete (to mimic kidneys)

Answer 16

hemodialysis

Question 17

when do we start dialysis ?

Answer 17

stage 4/5 ckd

• No response to diuretics
• Symptomatic Hyperkalemia
• Calciphylaxis (vascular calcification and skin necrosis)
• Ingestion of toxins that require dialysis for removal

Question 18

hemodialysis uses what scientific property to function?

Answer 18

diffusion

–> molecules move from high (blood) to low (dialysate) concentration

Question 19

hemodialysis care

Answer 19

-patients get hypothermic
-changes in loc/fatigue common
-risk for SEIZURES
- large voulme shifts –> hemodynamic instability
-cardiac arrest
-psychosocial issues

Question 20

what is continuous renal replacement therapy

Answer 20

“dialysis for unstable patient”

continuously for 24 hours a day and slowly runs a small amount of blood thru

Question 21

where is continuous renal replacement therapy done?

Answer 21

icu - 1:1 nurse ratio

Question 22

how is continuous renal replacement therapy different from hemodialysis in terms of its mechism of action?

Answer 22

Uses a filter with fine pores (unlike HD’s diffusion process) resulting in hemofiltration

–> avoids large volume shifts but provides same results