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18 Cards in this Set
- Front
- Back
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movement of fluid & molecules across a semi-permeable membrane from one compartment to another
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dialysis
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a dialysis technique in which substance is moved from the blood through a semi-permeable membrane and into a dialysis solution (dialysate).
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clinical dialysis
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why is dialysis done
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to correct fluid and electrolyte imbalances and remove waste products in renal failure
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how does peritoneal dialysis work
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the peritoneal membrane acts as the semipermeable membrane (filtration). accessed by inserting cath into abdominal wall (7-10 days after cath insertion it can begin)
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3 types of PD
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automated peritoneal dilaysis aka continuous cycler-assisted peritoneal dialysis
continuous ambulatory peritoneal dialysis nocturnal intermittent peritoneal dialysis |
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uses an automated cycler to perform 3-5 exchanges during the night
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automated peritoneal dilaysis aka continuous cycler-assisted peritoneal dialysis
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a fresh bag of dialysis solution goes into the abdomen. there is a 4-6 hrs of dwell time, after which the abdomen is drained & cycle is repeated
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continuous ambulatory peritoneal dialysis
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automated cycler at least 6 hrs or longer without a daylight exchange. is usually reserved for those who peritoneum is able to transport waste products very rapidly or for those who still have substantial remaining kidney function
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nocturnal intermittent peritoneal dialysis
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complications of PD
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exit site infection
peritonitis abdominal pain outflow problems hernias lower back problems bleeding pulmonary complications protein loss carb & lipid abnormalities encapsulating sclerosing peritonitis & loss of ultra filtration |
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artificial membrane used as semi-permeable membrane
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hemodialysis (HD)
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most difficult problems associated with HD & why
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obtaining vascular access
a very rapid blood flow is required |
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6 types of vascular access devices currently used in HD
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arteriovenous fistula (AVF)
arteriovenous grafts (AVG) temporary catheters semi-permeable caths subcutaneous ports shunts |
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complications of access devices
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infection
low blood flow problems due to clotting |
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pt care of access devices
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use only for dialysis
no blood pressure in access arm no tight jewelry or clothes over access device don't sleep with access are under body don't lift heavy ojbects or put pressure on access arm check pulse in access arm qd |
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complications of HD
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hypotension
muscle cramps loss of blood hepatitis sepsis disequilibrium syndrome |
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develops as a result of very rapid changes in composition of ECF. Solutes removed more rapidly in blood than CSF causing in fluid shift into the brain causing cerebral edema
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disequilibrium syndrome
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hand irrigation of foley cath
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done to remove clotted blood from thebladder and to ensure drainage of urine
use sterile NSS use 50cc irrigant instilled & then withdrawn - do slowly aseptic technique |
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continuous bladder irrigation (CBI)
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triple lumen cath needed
usually done following prostate surgery less incidence of painful bladder spasms rate of infusion is based on color of drainage. ideally urine should be pink w/o clots |
