Hemodialysis/Peritoneal Flashcards

1
Q

What is peritoneal dialysis?

A

drains excess fluids and toxins through peritoneal cavity (abdomen)

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2
Q

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

A

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

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3
Q

what are the complications of peritoneal dialysis?

A

hypotension
peritonitis
hemorrhage
infection
respiratory distress
protein loss

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4
Q

What are the advantages of peritoneal dialysis?

A

flexible
few hemodynamic changes
fewer dietary and fluid restrictions

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5
Q

what is dwell time?

A

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

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6
Q

what is dialysate?

A

dialyzing solution that contains electrolytes and water

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7
Q

what is the nursing care before PD (hospital)?

A

vital signs to get baseline
weight
labs

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8
Q

What is the nursing care after PD?

A

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

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9
Q

what is dry weight?

A

weight of pt without excess fluid

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10
Q

How do you maintain patency of PD access?

A

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

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11
Q

what are the contraindications for PD?

A

peritoneal adhesions
GI disease
ascites
abdominal surgery

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12
Q

What is hemodialysis?

A

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

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13
Q

How often is hemodialysis?

A

3x a week for 3-6 hours indefinitely

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14
Q

What are the advantages of hemodialysis?

A

more efficient clearance of waste
shorter time of treatment

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15
Q

what are the contraindications for hemodialysis?

A

hemodynamic instability
no vascular access
bleeding disorder

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16
Q

what are the complications for hemodialysis?

A

infection
hemorrhage
anemia
access site complications

17
Q

how do you confirm patency hemodialysis fistula?

A

check for a bruit and thrill

18
Q

Why would someone need hemodialysis? (Remember: AEIOU)

A

Acidosis
Electrolytes
Intoxication
Overload
Uremia

19
Q

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

A

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

20
Q

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

A

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

21
Q

What is the pre care for hemodialysis?

A

assess if you can administer bp meds
assess electrolytes

22
Q

what is the post care for hemodialysis?

A

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

23
Q

what is dialysis disequilibrium syndrome?

A

mental status changes from rapid reduction of electrolytes

24
Q

what are the s/s of disequilibrium syndrome?

A

Nausea
vomiting
headaches
fatigue
restlessness

25
What medications should be held before hemodialysis?
water soluble vitamins antibiotics antihypertensives digoxin
26
What are the advantages of a fistula?
using their own vein/artery longevity low infection and clot rate
27
what are the disadvantages of fistulas?
takes 1-6 months to mature requires needle sticks steal syndrome
28
What are the temporary vascular access devices and where are they placed?
subcutaneous or dialysis subclavian, internal jugular or femoral
29
what are the permanent vascular access devices used for dialysis and where are they placed?
AV fistula or graft forearm or upper arm AV graft can also be placed inner thigh