Hemodialysis Flashcards
advantages of an AV Fistula
permanent access, has a low infection & thrombosis risk, predictable
disadvantages of an AV fistula
cant use with diabetics/vascular disease, takes 3-4 months to mature before you can use it, bleeding occurs after needles are removed
care of fistula, DO NOTs
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
catheter advantages
easily inserted & removed, immediate use after insertion
catheter disadvantages
low flow rates, high rates of infection &thrombosis, only can use for 3-4 months, poor body image
subcutaneous access advantages
high flow rate, low rates of infection &thrombosis,easily implanted, immediate use after insertion,
Advantages of Hemodialysis
efficient clearance, increased tolerance, staff is always there to help, can get to know other pts/staff
Disadvantages of Hemodialysis
you have to travel to & from, sessions are 2-3 times/week lasting about 3-4 hours
Complications of Hemodialysis
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
If you have frequent transfusions because of chronic anemia, what disease are you at risk for with Hemodialysis?
hepatitis
Medications commonly held before dialysis
Antihypertensives, Vitamins,/Folic Acid, Diuretics, Narcotics (decrease BP), Morphine, Demeral, Electrolyte preparations(oral calcium/Rocal)
Diet for Hemodialysis
Limit Potassium, Phosphorus, fluid intake & salt
Why do you want to limit Phosphorus when pt is on hemodialysis?
because too much phosphorus can cause calcium to be pulled from the bones, which makes them brittle & can cause osteoporosis
Why do you want to limit fluid intake when pt is on hemodialysis?
it can prolong time needed for dialysis
Dialysis solution & how Peritoneal Dialysis works
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
Dwell time
the period that dialysis solution is in the abdomen
Continuous Ambulatory Peritoneal Dialysis (CAPD)
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
An exchange
solution is drained from abdomen and new solution is put into abdomen
How long does solution stay in abdomen with peritoneal dialysis?
4-6 hrs or more
Draining used dialysis solution & replacing it takes about how long? & how many times is it done a day?
30-40 mins ; 4 times a day
Continuous Cycler-Assisted Peritoneal Dialysis (CCPD)
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
When would a pt have to use both CAPD and CCPD?
If pt weighs more than 175 lbs or if the peritoneum filters waste slowly
Peritoneal Diet
limit salt & liquids but not as limited than those on hemodialysis, increase protein!, may have restrictions on potassium
Advantages of Peritoneal Dialysis
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
Disadvantages of Peritoneal Dialysis
Permanent catheter, infection, need space for supplies, daily dialysis routine,
Complications of Peritoneal Dialysis
Peritonitis r/t contamination of solution or tubing, respiratory distress, hyperglycemia, fluid imbalances, perforation of bladder or bowel, protein loss
s/s of peritonitis
rigid abdomen, abdominal pain, cloudy drainage,
Why would respiratory distress be a complication for peritoneal dialysis
due to upward displacement of diaphram b/o increased pressure in peritoneal cavity
If pts experience respiratory distress with peritoneal dialysis what other things might they experience
dyspnea, atelectasis, pneumonia, bronchitis
why is protein a complication in peritoneal dialysis
because it is lost thru passing in dialysate fluid
Why is hyperglycemia a complication in peritoneal dialysis?
because sugar is added to dialysate to increase drawing power for water out of system
