lewis ch 46 dialysis and kidney transplant Flashcards
who needs dialysis (AEIOU)
Acid-base problems Electrolyte problems Intoxications Overload of fluids Uremic symptoms
what should you assess before and after dialysis treatments (5)
- weight
- bp
- heart and lung sounds
- vascular access site
- peripheral edema
when is dialysis started
GFR <15 mL/min
Movement of solutes from an area of greater
concentration to an area of lesser
concentration
diffusion
Movement of fluid from an area of lesser
concentration of solutes to area of greater
concentration
osmosis
• Water and fluid removal
• Results when there is an osmotic gradient or
pressure gradient across membrane
• Excess fluid moves into dialysate
ultrafiltration
stage of peritoneal dialysis: -Prescribed amount of solution infused through established catheter over about 10 minutes • After solution infused, inflow clamp closed
inflow
stage of peritoneal dialysis: • Also known as equilibration • Diffusion and osmosis occur between patient’s blood and peritoneal cavity • Duration of dwell time varies, depending on method of PD
dwell
stage of peritoneal dialysis: • Lasts 15 to 30 minutes • May be facilitated by gently massaging abdomen or changing position • Ultrafiltration during PD depends on osmotic forces • Should return CLEAR
drain
2 examples of peritoneal dialysis systems
- automated peritoneal dialysis (APD)
- continuous ambulatory peritoneal dialysis (CAPD): manual exchange
how often do you check vital signs during hemodialysis
30-60 minutes
what determines the ultrafiltration of hemodialysis to be set
difference between last postdialysis weight and present predialysis weight
rejection of transplanted organ minutes to hours after
hyperacute
rejection of transplanted organ days to months after
acute
rejection of transplanted organ months to years after
chronic
