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connect artery and vein for heme
Internal AV graft
- looped graft internally between vein and artery
- external segment
- anastmosis of artery and vein, shunting arterial blood into vein
Hemed effectiveness measured by
fluid, solute, and urea removed from body
- dializing solution through catheter, remains for 1 h +, then removed.
- -catheter into abdomen in hc setting
- -implanted cath every night at home
avoid what foods?
- Electrolyte imbal, bleeding at cath site, cardiac ischemia, irreg hb, air emblysm, anemia, htn, pulm edema, hf, fluid accumulation, pericarditis, hyperkalemia, bone disease, hypocalcemia, periph neuro, pneu, sleep dis, vitamin D def, anxiety depression.
- -avoid excessive fl intake, salt, phosph rich foods, (cheese milk beans nuts p butter, dark cola, potassium-kiwi, dried fruit, banana, avo) antacids and lax
Osmotic diuretics names
Osmotic diuretics used for
- edema, intra oc pressure k function in ARF
- IV only
How do they work, where do they work, side effects?
- increase plasma osmotic pressure, proximal convaluted, elevates glom titrase, dec cerebral edema,
- se's pulm edema, renal f, extrav, fl imbal, hypotension
what are sx of hyper AND hypokalemia?
- EKG changes
- muscle weakness
- flaccid paralysis
- cardiac arrest
What are only signs of hypokalemia?
- diminished DTR
- leg cramps
- Think- not enough K+ to have dtrs, reflexes, keep leg from cramping, and you're peeing all of it out
What are only sx of hyperkalemia?
- peaked T waves
- V/V/D (think too much, so overflowing K+)
- numbness and tingling
- -think- you are full of K+ because you can't pee it out and are so full you are numb and tingling and throwing up and even your T wave is high
What are sx of both hyper and hypocalcemia?
- cardiac dysrhythmias
- cardiac arrest
What causes hypocalcemia?
citrate, booze, alkalosis, CRF, anticonvulsants, diuretics, def of PTH, def of Vitamin D, Increased Mg, thy surg, burns, low albumin
4.5-5.2 or 8?
- muxcle spasms of hands and feet
- hyperactive dtr
- ca deposits in body tissues
- laryngeal spasms
- You don't have enough bone so your muscles are freaking out and reflexes, you have deposits in body tissues not where they're supposed to be, and you can't even swallow
multiple myeloma, high intake ca and antacids, inc pth
What are only sx hypercalcemia?
- paralytic ileus
- renal stones
- decreasedd dtr
- decresed muscle tone
- lethargy and coma Think- so much bone that nothing else is working, dtr, muscles, think of trying to pee out extra bone and trying to pee out bone
- hypotension, vasodilation, heat, thirst, NV, loss of dtr, resp depression, hypotension
- anorexia, mental changes
- seiz, cramps, tetany, dysphagia
-Thiazides, how often given and for what?
-Where do they work?
-how do they work?
- -most common, mild HTN and systemic edema
- Chlorothiazide, Hydrochlorothiazide (often w ACE), Metolazone (zaroxolyn),
- -early distal convoluted
- -impair Na Cl reab, leads to excr ofwater and elytes
- -hypokalemia, alkalosis, not effective in renal disease hold for hypotension
K+ sparing diuretics, names?
How do they work?
where do they work?
- Spironolactone, aldactone,
- Used to limed to limit K wasting of other Diuretics
- Inhinit salt reabsorb and K secretion
- distal convoluted
- Hyperkalemia, aces an add to this, ASA can inc diuretic eff, can inc digoxin
Loop diuretics, names?
- Nephrotic synd, CHF, CRF, pulm edema, hepatic cirrhosis
- most potent, anble to move large volumes quickly through kids by inhib tubular reab of Na and Cl
- SEs- hypokalemia, and other elytes, hypochloremic alkalosis, dehyd, vertigo, hypotension, circ collapse