Hemodialysis/Peritoneal

Question 1

What is peritoneal dialysis?

Answer 1

drains excess fluids and toxins through peritoneal cavity (abdomen)

Question 2

How often is peritoneal dialysis? How long is the process?

Answer 2

4x a day, 7 days a week
3-40 minutes

Question 3

what are the complications of peritoneal dialysis?

Answer 3

hypotension
peritonitis
hemorrhage
infection
respiratory distress
protein loss

Question 4

What are the advantages of peritoneal dialysis?

Answer 4

flexible
few hemodynamic changes
fewer dietary and fluid restrictions

Question 5

what is dwell time?

Answer 5

the amount of time prescribed by the nephrologist for the dialysate to stay in the peritoneal cavity

Question 6

what is dialysate?

Answer 6

dialyzing solution that contains electrolytes and water

Question 7

what is the nursing care before PD (hospital)?

Answer 7

vital signs to get baseline
weight
labs

Question 8

What is the nursing care after PD?

Answer 8

dry weight
repeat labs
vital signs q 15-30 mins
check dressing
monitor respiratory

Question 9

what is dry weight?

Answer 9

weight of pt without excess fluid

Question 10

How do you maintain patency of PD access?

Answer 10

sterile technique when cleaning exit site
monitor for infection
flush with sterile saline regularly

Question 11

what are the contraindications for PD?

Answer 11

peritoneal adhesions
GI disease
ascites
abdominal surgery

Question 12

What is hemodialysis?

Answer 12

artificial kidney dialyzer connected to a machine outside body to filter waste from blood

Question 13

How often is hemodialysis?

Answer 13

3x a week for 3-6 hours indefinitely

Question 14

What are the advantages of hemodialysis?

Answer 14

more efficient clearance of waste
shorter time of treatment

Question 15

what are the contraindications for hemodialysis?

Answer 15

hemodynamic instability
no vascular access
bleeding disorder

Question 16

what are the complications for hemodialysis?

Answer 16

infection
hemorrhage
anemia
access site complications

Question 17

how do you confirm patency hemodialysis fistula?

Answer 17

check for a bruit and thrill

Question 18

Why would someone need hemodialysis? (Remember: AEIOU)

Answer 18

Acidosis
Electrolytes
Intoxication
Overload
Uremia

Question 19

What is the difference between an AV fistula and AV graft?

Answer 19

fistula is a direct connection between artery and vein
graft is synthetic

Question 20

What is the nursing care for pts with a fistula or graft?

Answer 20

never take BP from extremity used for dialysis
no IV’s on that arm
assess distal pulses and circulation
elevate after surgery

Question 21

What is the pre care for hemodialysis?

Answer 21

assess if you can administer bp meds
assess electrolytes

Question 22

what is the post care for hemodialysis?

Answer 22

assess for hypotension, headaches, N/V, malaise, or bleeding
avoid lifting heavy objects

Question 23

what is dialysis disequilibrium syndrome?

Answer 23

mental status changes from rapid reduction of electrolytes

Question 24

what are the s/s of disequilibrium syndrome?

Answer 24

Nausea
vomiting
headaches
fatigue
restlessness

Question 25

What medications should be held before hemodialysis?

Answer 25

water soluble vitamins
antibiotics
antihypertensives
digoxin

Question 26

What are the advantages of a fistula?

Answer 26

using their own vein/artery
longevity
low infection and clot rate

Question 27

what are the disadvantages of fistulas?

Answer 27

takes 1-6 months to mature
requires needle sticks
steal syndrome

Question 28

What are the temporary vascular access devices and where are they placed?

Answer 28

subcutaneous or dialysis
subclavian, internal jugular or femoral

Question 29

what are the permanent vascular access devices used for dialysis and where are they placed?

Answer 29

AV fistula or graft
forearm or upper arm
AV graft can also be placed inner thigh