Rena system Flashcards
AVfistula
Av fistula(requires several weeks to months to mature before it can be used). He grabbed a big AvGraft : (can be used to 2more 4weeks after placement). Maturing of the fistula is aided by having the client perform hand exercises, such as squeezing rubber ball, that increases blood flow through the vein.
 Nursing Consideration -dialysis
obtain consent , medication-might be on hold.
Assess vitals and lab works, obtain daily weight.
Assess patency of AV fistul/graft , presence of Bruit,palpable thril,distal pulses.
Restrictions on the extremity with AVF/G. Avoid taking blood pressure.
Do not administer injection through AVF/G
do not perform the vein puncher Or insert I/V lines.
 confrontational dialysis 
 assess for the following:
complications:hypotension, clotting vascular assess, headache, muscle cramps, bleeding. Indications :of bleeding and/or infection at the assess site .
Send some disequilibrium syndrome
Due to too rapid decreases in BUN and fluids- can result in cerebral edema, and ICP sign include nausea/vomiting, headache, fatigue, confusion, convulsion, coma.
Signs of hypovolemia, (hypotension , dizziness, tachycardia).
peritoneal dialysis 
Instill dailysate solution into Pétronille cavity and drain. The peritoneum serves as the filtration membranes.
The client may feel fullness when the dialysate dwelling
Continues ambulatory peritoneal dialysis
Continue ambulatory Pétronille dialysis is usually done 7 days a week, for 4 to 8 hours. client may continue normal activities during CAPD.
Continues cycle peritoneal dialysis CCPD-the exchange occurs at night while the client is sleeping. assist site care: strict sterile technique.
Peritoneal dialysis monitoring
Monitor weight ,serum electrolytes , creatinine,bun, and blood glucose (might need insulin).
Warm the dialysate prior to instilling. avoid the use of microwaves, which cause uneven heating. Monitor the color (clear light yellow is expected). And amount (expected to equal or exceed amount of dialysate inflow)of outflow.
Cloudy -infection.
Reposition the client if inflow or outflow is in adequate.
Movement of the client will help disseminate the fluid throughout the abdomen.
Acute renal failure (acute kidney injury)
Sudden cessation of renal function – when blood flow to the kidneys his significantly compromised
Acute Kidney injury compromised:four phases
Onset-begins with onset of the event ,ends when oligoria develops, and lasts for hours to days. oligoria-begins with the kidney insult, urine output is 100 to 400 ml/24 hours with or without diuretics, and lost for 1to 3 weeks.
Diuretics-begins when the kidneys start to recover,diuresis of large amount of fluid occurs, and can last for 2 to 6 weeks.
Recovery-continues until kidney function is fully restored and can take up to 12 months.
Acute kidney injury causes
Prerenal:hypoperfusion, obstructed renal artery blood flow. Hypovolemia,water and electrolyte loss. Hemorrhage, Loss plasma volume cardiac failure, PE hypertension, sepsis, shock. Intrarenal Renal: prolonged renal ischemia, (decreased urine output ,always products stay nephrotoxins:poisons,Radiation’s chemicals, cancer tissues intra-tubular obstruction/necrosis immunological damage, pyelonephritis  post renal: urethral obstruction, edema, tumor, stones, clots bladders outlet obstruction, BPH, you return structure, neurogenic bladder (stiff flaccid bladder, paralyzed)
Chronic renal failure in neuro, Cardiovascular
Neurologic-lethargy , decreased in attention span, slurred speech, tremors, seizures, coma.
Cardiovascular cardiovascular - fluid overload, hypertension, dysrhythmias, heart failure, orthostatic hypotension
Chronic renal failure respiratory, hematology.
Respiratory-uremic halitosis, (NHCO3- by product in saliva, urea). With deep sighing, yawning, shortness of breath, tachypnea, hyperpnea, Kussmaul breathing.
Hamatologyanemia -pallor, weakness, dizziness, Ekhymosis, petechiae, Melena.
chronic renal failure:body systems- gastrointestinal, muscular skeleton, renal, skin.
gastrointestinal -due to fluid electrolyte.-ulcers in the mouth and throat, foul breath, blood in stool, nausea, vomiting.
musculo skeletal-thin fragile bone due to low calcium
renal- urine contains protein, blood,particles; in the amount color ,concentration
Skin decreasing skin turgor, yellow cast tonskin, dry, pruritis,urea crystalline skin,uremic frost.
Special consideration for chronic renal failure
For anemia administer epoetin Alfa (epogen,procrit), Darbypoetin Alfa( Aranesp)
Administer blood transfusion if prescribed for anemia.
instruct the client to avoid antacids containing magnesium.
administration of acetylsalicylic acid (aspirin)or(NSAIDS) to prevent gastrointestinal bleeding.
Avoid administering anti-microbial medication (example aminoglycosides and amphotericin B),
angiotension-converting converting enzymes inhibitor and angiotensin receptor blocker’s, and IV contrast dye, which are nephrotoxic.
Nursing consideration for chronic renal failure
Monitor for signs of hypervolemia, hypovolemia,dehydration,signs of congestive heart failure, pulmonary edema, signs of infection, peripheral neuropathy.
Monitor for hyperkalemia – cardiac monitoring dysrhythmias. Provide low potassium diet if prescribed for hyperkalemia.avoid potassium sparing diuretics.
