Renal Flashcards
dwell time & what to do during peritoneal dialysis
20-30 mins dwell time &
-assess for respi distress
if (+), DRAIN immediately
-position Fowler’s
-weigh daily
-v/s
insufficient outflow during peritoneal dialysis
side lying/ambulate
check for
-kinks
-constipation/distended abdomen
-clots (mgt: give anticoag like alteplase)
2 types of peritoneal dialysis (pd)
- Continuos Ambulatory PD
Day: 3-5 exchange
Night: 1 longer exchange - continuous cyclic pd or automatic pd
Day: 1 exchange
Night: 10-12 hrs attached to a machine
risks of peritoneal dialysis
- peritonitis (rigid/board like stomach, fever)
- hernia
- wt gain (dialysate ⬆️ sugar)
dull pain suprapubic area
cystitis or lower UTI
sudden stabbing pain radiating to the groin and/or genitals (ureteral colic)
renal stones
flank pain (costovertebral) raditing to umbilicus
nephritis
(glomerulo-, pyelo- etc.)
straining urine to identify composition of stones
Ca Oxalate
Ca Phosphate
Struvite
Uric Acid
Cystine (amino acid byproduct)
complxn of renal calculi
(backflow of urine to the kidney)
hydronephrosis
hydroureteronephrosis
Post OP TURP pain
-check amount & urine characteristics
-manual irrigation w/ sterile h2o/NSS until urine is clear and no clots
post op TURP Mgt
- fluids
- laxatives, ⬆️ fiber diet
- ambulate
- ❌ heavy lifting
- ❌ long drive/prolonged sitting
- ❌ sex for 4-6weeks
post op TURP CBI
-3 way catheter for irrigating soln, bulb inflation, drainage
t/f: for renal calculi massage flank
f: might cause migration of stones leading to more pain
apply heat pads
AV Fistula
-no blood pressure, blood extraction on the side of the fistula
-report immediately for numbness, pallor, paresthesia, weak pulse or tingling (arterial steal syndrome leading to distal ischemia)
-assess several times for or vibration, swoosh, bruit (stethoscope), thrill (palpate)
-hand grip exercises through small sponge for maturity of fistula
av fistula maturity and what to use temporarily
2-3 mos but can be already used at 2nd week, so use of av shunt
