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What is Dialysis?
Movement of fluid and molecules across a semipermeable membrane from one compartment to another.
What are the two methods of dialysis?
Peritoneal Dialysis(PD) and Hemodialysis(HD)
Requires permanent access to the bloodstream through a fistula.
What is a fistula:
An unusual opening between two organs. They are ofter created near the wrist and connected to an artery and a vein.
Explain Peritoneal Dialysis:
uses the peritoneal cavity a semipermeable membrane and is less efficient than hemodialysis.
When does dialysis normally begin?
When the GFR (or creatinine clearance) is less than 15ml/min.
Movement of solutes from an area of greater to an area of lesser concentration.
Movement of fluid from an area of lesser to an area of great concentration of solutes.
(Water and Fluid removal) results when there is an osmotic gradient or pressure gradient across the membrane.
What are the three phases of the PD cycle?
- Inflow (fill)
- Dwell (equilibration)
- & Drain
a certain amount of solution is infused through an established catheter over 10 minutes.
Diffusion and osmosis occur between the patients blood and the peritoneal cavity. Takes 20-30 minutes or as much as 8 hours.
What are the 2 types of Peritoneal Dialysis?
- Automated Peritoneal Dialysis (APD)
- Continuous Ambulatory Peritoneal Dialysis (CAPD)
Automated Peritoneal Dialysis
A cycler is used to deliver the dialysate. It is times and controls the fill, dwell, and drain. This is safe to use at night.
What are the 2 most common infections of the peritoneal cath exit site?
- Staph. Aureus
- & Staph. Epidermidis (from skin flora)
For heomdialysis what are the types of vascular access?
- Arteriovenous fistulas (AVF)
- Arteriovenous grafts (AVG)
- Temp. and semipermanent caths
- Subcutaneous ports
A reslut of very rapid change in the composition of the extracellular fluid. Symptoms: nausea, vomiting, confusion, restlessness, headaches, twitching, jerking, and seizures.
What is the main nursing goal to help the patient on dialysis?
Help the patient regain or maintain positive self-esteem and control of his or her life to continue to be productive in society.
Complications of Hemodialysis:
- Muscle Cramps
- Blood Loss
- Disequilibrium Symdrome
What kind of diet does a patient on hemodialysis need?
- High Quality protein
- Low potassium
- Low sodium
- Low phosphate
Difference between AV fistula and a graft:
AV fistula much less likely to clot than grafts but takes longer to be used for dialysis. Neither of them impact needle size or patient moblilty.
Why do you need thrill and bruit in the fistula site?
Indicates adequate blood flow through the fistula.
If you have had a chronic kidney disease and are on dialysis now what food changes will be made?
more protein will be allowed in the patients' diet.
What is a plus to using CAPD verses HD?
Diabetic patients will have fewer dialysis related complications with CAPD
What things should be monitored after kidney transplant?
Urine output hourly, BUN, Creatinine, Electrolytes, incision, VS, and fluid volume status.