Hemodialysis/Peritoneal Flashcards
What is peritoneal dialysis?
drains excess fluids and toxins through peritoneal cavity (abdomen)
How often is peritoneal dialysis? How long is the process?
4x a day, 7 days a week
3-40 minutes
what are the complications of peritoneal dialysis?
hypotension
peritonitis
hemorrhage
infection
respiratory distress
protein loss
What are the advantages of peritoneal dialysis?
flexible
few hemodynamic changes
fewer dietary and fluid restrictions
what is dwell time?
the amount of time prescribed by the nephrologist for the dialysate to stay in the peritoneal cavity
what is dialysate?
dialyzing solution that contains electrolytes and water
what is the nursing care before PD (hospital)?
vital signs to get baseline
weight
labs
What is the nursing care after PD?
dry weight
repeat labs
vital signs q 15-30 mins
check dressing
monitor respiratory
what is dry weight?
weight of pt without excess fluid
How do you maintain patency of PD access?
sterile technique when cleaning exit site
monitor for infection
flush with sterile saline regularly
what are the contraindications for PD?
peritoneal adhesions
GI disease
ascites
abdominal surgery
What is hemodialysis?
artificial kidney dialyzer connected to a machine outside body to filter waste from blood
How often is hemodialysis?
3x a week for 3-6 hours indefinitely
What are the advantages of hemodialysis?
more efficient clearance of waste
shorter time of treatment
what are the contraindications for hemodialysis?
hemodynamic instability
no vascular access
bleeding disorder
what are the complications for hemodialysis?
infection
hemorrhage
anemia
access site complications
how do you confirm patency hemodialysis fistula?
check for a bruit and thrill
Why would someone need hemodialysis? (Remember: AEIOU)
Acidosis
Electrolytes
Intoxication
Overload
Uremia
What is the difference between an AV fistula and AV graft?
fistula is a direct connection between artery and vein
graft is synthetic
What is the nursing care for pts with a fistula or graft?
never take BP from extremity used for dialysis
no IV’s on that arm
assess distal pulses and circulation
elevate after surgery
What is the pre care for hemodialysis?
assess if you can administer bp meds
assess electrolytes
what is the post care for hemodialysis?
assess for hypotension, headaches, N/V, malaise, or bleeding
avoid lifting heavy objects
what is dialysis disequilibrium syndrome?
mental status changes from rapid reduction of electrolytes
what are the s/s of disequilibrium syndrome?
Nausea
vomiting
headaches
fatigue
restlessness