Unit 8 - 6 Physiology

Front 1

Preferred method for hemodialysis

Back 1

arteriovenous fistula; The preferred access for hemodialysis is an AVF, wherein an artery is directly joined to a vein. Two needles are placed into the vein for dialysis. One needle is used to draw blood and run through the dialysis machine. The second needle is to return the cleansed blood. AVFs are less likely to get infected or develop clots than any other types of dialysis access.

Front 2

second preferred method for hemodialysis

Back 2

Arteriovenous graft: An arteriovenous graft is placed in those who have small veins or in whom a fistula has failed to develop. The graft is made of artificial material and the dialysis needles are inserted into the graft directly.

Front 3

utility of central venous catheters in hemodialysis vascular access

Back 3

A catheter may be either temporary or permanent. These catheters are placed into a large blood vessel either in the neck or the groin. While these catheters provide an immediate access for dialysis, they are prone to infection and may also cause blood vessels to clot or narrow.

Front 4

utility of shunts in dialysis

Back 4

This technique was used in the early days of dialysis. Two artificial catheters were placed in the artery and vein of the forearm and provided blood access. You did not need to have needle sticks each time you dialyzed, but the complication rate was quite high.

Front 5

peritoneal access in dialaysis

Back 5

A catheter is implanted into the abdominal cavity. This catheter is a thin tube made of a soft flexible material, usually silicone or polyurethane. The catheter usually has one or two cuffs that help hold it in place.

Front 6

middle molecule mw

Back 6

300-12,000 daltons

Front 7

which markers are used to detect effective dialysis

Back 7

creatine and urea (although there are many other undiscovered/proven toxins that are unmeasured)

Front 8

reduction of urea or creatinine with concurrent flow

Back 8

50% at most

Front 9

reduction of urea or creatinine with countercurrent flow

Back 9

70-80% (bc initial diasylate coming in has lowest conc and initial blood coming in ha shighest conc, max time for removal)

Front 10

why add heparin to incoming blood?

Back 10

prevents blood from clotting in the dialyzor

Front 11

function of air trap after blood goes through dialyzor

Back 11

makes sure no bubbles/air gets into pts circulation; shuts off dialysis if malfunction detected

Front 12

protamine sulfate

Back 12

binds heparin on venous side before blood enters the patient again (tight heparin lock around dialyzor)

Front 13

countercurrent flow in vasa recta for dialysis

Back 13

ccf in dialysis reduces solute concentrations
ccf in vasa recta keeps the medullary concentration the same

Front 14

dialysis disequilibrium syndrome

Back 14

BUN conc rapidly reduced -> decreased blood osmolarity promotes fluid movement into cells -> cerebral edema -> neurological symptoms

Front 15

post dialysis rebound

Back 15

compounds removed from plasma rapidly but doesnt leave time for solutes to move from interstitial fluid into plasma so you have a large post dialysis rebound when dialysis is stopped with a fast rate of flow

Front 16

why consume more protein in decreased renal function

Back 16

increased protein reduces the nitrogen processed by the kidney

focus is to SLOW further renal damage

Front 17

focus rx in chronic kidney disease

Back 17

stricter dietary reccomedations to prevent buildup of toxins the kidneys are unable to handle

goal is to delay initiation of dialysis

Front 18

goal for pts w moderately reduced renal function

Back 18

good energy intake; reduce further kidney damage