RRT Flashcards
When do you start dialysis?
AEIOU • Acidosis • Electrolyte imbalance (hyperkalaemia) • Intoxication • Overloaded with fluid • Uraemic encephalopathy/pericarditis
What toxins can be removed with dialysis?
SLIME o Salicylic acid o Lithium o Isopropanol o Magnesium-containing laxatives o Ethylene glycol
How many times is HD done per week?
4hrs 3X/week
How is HD connected to the body?
HD line or AV fistula
What is a HD line?
o Tube inserted into subclavian or jugular vein with a tip that sits in the SVC or RA
What is an AV fistula?
o Artificial connection between an artery and vein
o Takes 3 months to mature
When examining a fistula, what do you look for?
- Skin integrity
- Aneurysms
- Palpable thrill (pulsation = problem with fistula outflow)
- Machinery murmur
- Previous fistula (look at the other arm)
- Recent use? -> dressing, needle sites
What are the complications of a HD line?
- Infection
- Blood clots
What are the complications of an AV fistula?
- Aneurysm
- Infection
- Thrombosis
- Stenosis
- STEAL syndrome
- High-output HF
What causes STEAL syndrome?
- Inadequate blood flow to the limb distal to the AV fistula causing distal ischaemia
- Blue/cold hands
What causes high-output HF?
• Blood flows quickly from arterial to venous system causing a rapid return of blood to the heart
What is PD?
Uses peritoneal membrane as a filtration membrane. Ultrafiltration occurs from the blood, across the peritoneal membrane and into the dialysis solution. Dialysis solution is then replaced.
What are the types of PD?
• Continuous ambulatory PD (CAPD) 4X/day -> Dialysis solution in peritoneum at all times
• Automated PD (APD) -> happens at night
Complications:
What are the complications of PD?
- Bacterial peritonitis
- Peritoneal sclerosis
- Ultrafiltration failure
- Weight gain
- Psychosocial effects
What are the complications of RRT?
- CVD
- Protein-calorie malnutrition
- Renal bone disease
- Infection
- Amyloid
