Hemodialysis

Question 1

advantages of an AV Fistula

Answer 1

permanent access, has a low infection & thrombosis risk, predictable

Question 2

disadvantages of an AV fistula

Answer 2

cant use with diabetics/vascular disease, takes 3-4 months to mature before you can use it, bleeding occurs after needles are removed

Question 3

care of fistula, DO NOTs

Answer 3

do not: carry heavy items on accessed arm, sleep on that arm, wear clothing or jewelry that binds that arm, no blood draws or BPs on that arm, injections into fistula or graft, no creams or lotions

Question 4

catheter advantages

Answer 4

easily inserted & removed, immediate use after insertion

Question 5

catheter disadvantages

Answer 5

low flow rates, high rates of infection &thrombosis, only can use for 3-4 months, poor body image

Question 6

subcutaneous access advantages

Answer 6

high flow rate, low rates of infection &thrombosis,easily implanted, immediate use after insertion,

Question 7

Advantages of Hemodialysis

Answer 7

efficient clearance, increased tolerance, staff is always there to help, can get to know other pts/staff

Question 8

Disadvantages of Hemodialysis

Answer 8

you have to travel to & from, sessions are 2-3 times/week lasting about 3-4 hours

Question 9

Complications of Hemodialysis

Answer 9

infectious disease, frequent blood transfusions due to chronic anemia (which puts you at risk for hepatitis), AIDS, hemorrhage during or immediately after due to heparin

Question 10

If you have frequent transfusions because of chronic anemia, what disease are you at risk for with Hemodialysis?

Answer 10

hepatitis

Question 11

Medications commonly held before dialysis

Answer 11

Antihypertensives, Vitamins,/Folic Acid, Diuretics, Narcotics (decrease BP), Morphine, Demeral, Electrolyte preparations(oral calcium/Rocal)

Question 12

Diet for Hemodialysis

Answer 12

Limit Potassium, Phosphorus, fluid intake & salt

Question 13

Why do you want to limit Phosphorus when pt is on hemodialysis?

Answer 13

because too much phosphorus can cause calcium to be pulled from the bones, which makes them brittle & can cause osteoporosis

Question 14

Why do you want to limit fluid intake when pt is on hemodialysis?

Answer 14

it can prolong time needed for dialysis

Question 15

Dialysis solution & how Peritoneal Dialysis works

Answer 15

A mixture of minerals and sugar dissolved in water that travels through the soft tube in the abdomen. the sugar draws wastes, chemicals, & extra water from the blood vessels in the peritoneal membrane into the dialysis solution

Question 16

Dwell time

Answer 16

the period that dialysis solution is in the abdomen

Question 17

Continuous Ambulatory Peritoneal Dialysis (CAPD)

Answer 17

blood is always being cleaned. the dialysis solution passes from a plastic bag thru the catheter & into the abdomen where it stays for hrs & is drained later

Question 18

An exchange

Answer 18

solution is drained from abdomen and new solution is put into abdomen

Question 19

How long does solution stay in abdomen with peritoneal dialysis?

Answer 19

4-6 hrs or more

Question 20

Draining used dialysis solution & replacing it takes about how long? & how many times is it done a day?

Answer 20

30-40 mins ; 4 times a day

Question 21

Continuous Cycler-Assisted Peritoneal Dialysis (CCPD)

Answer 21

uses a machine (cycler) to fill & empty abdomen 3-5 times during the night while sleeping. In morning, client fills abdomen with solution and has a dwell time of the entire day

Question 22

When would a pt have to use both CAPD and CCPD?

Answer 22

If pt weighs more than 175 lbs or if the peritoneum filters waste slowly

Question 23

Peritoneal Diet

Answer 23

limit salt & liquids but not as limited than those on hemodialysis, increase protein!, may have restrictions on potassium

Question 24

Advantages of Peritoneal Dialysis

Answer 24

less complex, can be used with pts who have vascular access probs, no needles, diet less strict, immediate life-threatening events (hemorrage, disequilibrium syndrome) less likely to happen

Question 25

Disadvantages of Peritoneal Dialysis

Answer 25

Permanent catheter, infection, need space for supplies, daily dialysis routine,

Question 26

Complications of Peritoneal Dialysis

Answer 26

Peritonitis r/t contamination of solution or tubing, respiratory distress, hyperglycemia, fluid imbalances, perforation of bladder or bowel, protein loss

Question 27

s/s of peritonitis

Answer 27

rigid abdomen, abdominal pain, cloudy drainage,

Question 28

Why would respiratory distress be a complication for peritoneal dialysis

Answer 28

due to upward displacement of diaphram b/o increased pressure in peritoneal cavity

Question 29

If pts experience respiratory distress with peritoneal dialysis what other things might they experience

Answer 29

dyspnea, atelectasis, pneumonia, bronchitis

Question 30

why is protein a complication in peritoneal dialysis

Answer 30

because it is lost thru passing in dialysate fluid

Question 31

Why is hyperglycemia a complication in peritoneal dialysis?

Answer 31

because sugar is added to dialysate to increase drawing power for water out of system