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Urinary > Dialysis > Flashcards

Dialysis Flashcards

1
Q

What is the purpose of dialysis?

A

To preform the filtration tasks of the kidneys artificially

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2
Q

What are the indications for dialysis?

A

A – Acidosis
E – Electrolyte abnormalities
I – Intoxication
O – Oedema
U – Uraemia symptoms

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3
Q

What type of acidosis requires dialysis?

A

Severe and not responding to treatment

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4
Q

What electrolyte abnormalities require dialysis?

A

Severe and unresponsive hyperkalaemia

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5
Q

What type of oedema requires dialysis?

A

Severe and unresponsive pulmonary oedema

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6
Q

What is the most common form of renal replacement therapy?

A

Haemodialysis

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7
Q

What does haemodialysis involve?

A

Regular filtration of the blood through a dialysis machine in hospital

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8
Q

How often do patients require haemodialysis a week?

A

3 times per week

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9
Q

How long does each session of haemodialysis last?

A

3-5 hours

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10
Q

What are the options for access to blood supply for patients undergoing haemodialysis?

A

Tunnelled cuffed catheter
Arterio-venous fistula

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11
Q

What is a AV fistula?

A

An artificial connection between an artery to a vein

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12
Q

When does an AV fistula need to be created prior to starting haemodialysis?

A

8 weeks

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13
Q

Where is the AV fistula for haemodialysis usually created?

A

Radio-cephalic
Brachio-cephalic

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14
Q

What is a tunnelled cuff catheter?

A

A tube inserted into the subclavian or jugular vein with a tip that sits in the superior vena cava or right atrium.

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15
Q

What is peritoneal dialysis?

A

Renal replacement therapy where the filtration occurs within the patient’s abdomen

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16
Q

What is used as the filtration membrane in peritoneal dialysis?

A

The peritoneal membrane

17
Q

How is the dialysis solution administered in peritoneal dialysis?

A

It is injected into the abdominal cavity through a permanent catheter

18
Q

What is the dialysis solution made up of for peritoneal dialysis?

A

High dextrose concentration

19
Q

What happens in peritoneal dialysis?

A

The high dextrose concentration of the solution draws waste products from the blood into the abdominal cavity across the peritoneum

20
Q

What happens after dwell time in peritoneal dialysis?

A

The dialysis solution is drained removing waste products and exchanged for new dialysis solution

21
Q

What are the two different types of peritoneal dialysis?

A

Continuous ambulatory peritoneal dialysis (CAPD)
Automated peritoneal dialysis (APD)

22
Q

What is continuous ambulatory peritoneal dialysis (CAPD)?

A

There is dialysis solution in the abdomen at all times

23
Q

What is Automated peritoneal dialysis (APD)?

A

A dialysis machine fills and drains the abdomen while the patient is sleeping

24
Q

How often is fluid changed and how long does APD take?

A

3-5 exchanges over 8-10 hours each night

25
Q

How often is the fluid in CAPD changed?

A

2 litres changed 4 times a day

26
Q

What is the main complication of peritoneal dialysis?

A

Bacterial peritonitis

27
Q

What bacterial usually causes bacterial peritonitis?

A

Staphylococcus epidermidis.

28
Q

How does a patient with bacterial peritonitis present?

A

Abdominal pain
Fever
Cloudy dialysis bag

29
Q

What are the possible complications of haemodialysis?

A

Cardiovascular disease- endocarditis and arrhythmias
Disequilibration syndrome

30
Q

What are the possible complications of an AV fistula

A

STEAL syndrome
Stenosis
Aneurysm
High output heart failure

31
Q

What is STEAL syndrome?

A

Inadequate blood flow to the limb distal to the AV fistula

32
Q

What does steal syndrome cause?

A

Diverts blood away from where it was supposed to supply and straight into the venous system

33
Q

What does STEAL syndrome result in?

A

Distal limb ischaemia

34
Q

What is Disequilibration syndrome?

A

Acute cerebral oedema due to rapid extraction of osmotically active substances

35
Q

How can an AV fistula result in high output hear failure?

A

Blood flows quickly from arterial to the venous system through the fistula
There is rapid return of blood to the heart
Increases the pre-load in the heart

36
Q

What is the most common cause of death on dialysis?

A

Ischaemic heart disease

Urinary (38 decks)

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