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Renal Exam 2 > Part 2 Dialysis > Flashcards

Part 2 Dialysis Flashcards

1
Q

HD Intradialytic Complications

A 
HypoTN
Cramps
Pruritis
N/V
Headache
Chest pain
Fever and chills
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2
Q

Causes of hypoTN

A

Hypovolemia
Anti-HTN meds or meal prior to HD
Dry weight set too low
Acetate dialysis (dilation)

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3
Q

Acute management of hypoTN

A

Trendelenburg position
Decrease ultrafiltration rate
100-200 mL of IV NS

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4
Q

Non-pharm prevention of hypoTN

A

Bicarbonate dialysate

Avoid food before or during HD

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5
Q

Pharm prevention of hypoTN

A

Midodrine before HD
Fludrocortisone before HD
Levocarnitine after HD
Sertraline daily

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6
Q

Causes of muscle cramps

A

Dehydration

Sodium too low

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7
Q

Treatment of cramps

A

100-200 mL IV NS

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8
Q

Prevention of cramps

A

Dialysate sodium
Stretching, massage, flexing
Vit E

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9
Q

Management/prevention of pruritis

A 
Biocompatible dialyzers
Capsaicin cream
Antihistamines
Cholestyramine
Charcoal
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10
Q

Vascular access complications

A

Dysfunction (decreased blood flow)
Fistulas/grafts: aneurysm and stenosis
Catheters: thrombosis or infection

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11
Q

Intrinsic thrombosis

A

Within the lumen

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12
Q

Prevention/treatment of intrinsic thrombosis

A

Saline, heparin, alteplase lock to prevent

Saline flush or alteplase instillation to treat

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13
Q

Extrinsic thrombosis

A

At the tip

Fibrin sleeve

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14
Q

Prevention/treatment of extrinsic thrombosis

A

Replacement of catheter

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15
Q

PD complications

A 
Mechanical
Pain
Metabolic
Membrane damage
Infections
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16
Q

Peritonitis

A 
Higher in CAPD than APD
Staph epidermidis (G+)
17
Q

Peritonitis diagnostic tests

A

Cloudy fluid and/or ab pain and/or fever
WBC >100
Start abx

18
Q

Empiric therapy for G+

A

Vanco

19
Q

Empiric therapy for G-

A

AG, cephtazidime, cefepime, carbapenem, FQ or aztreonam

20
Q

Empiric therapy adminstration

A

Intraperitoneal

21
Q

Enterococus treatment

A

Ampicillin 125mg/L
Add AG
Treat for 21 days***

22
Q

MSSA treatment

A

Nafcillin/oxacillin

Treat for 21 days***

23
Q

MRSA treatment

A

Vanc or clindamycin

Treat for 21 days***

24
Q

MRSA treatment

A

Vanc or clindamycin

Treat for 21 days***

25
Q

G- not pseudo or stenotrophomonas treatment

A

Treat for 14 days

26
Q

Pseudo treatment

A

Treat for 21 days

27
Q

Stenotrophomonas treatment

A

Bactrim

Treat for 21 days

28
Q

Multiple G- and/ore anaerobes treatment

A

Add metro

Treat for 21 days

29
Q

Multiple G- and/ore anaerobes treatment

A

Add metro

Treat for 21 days

Renal Exam 2 (10 decks)

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