Adequacy of Dialysis Flashcards
What is the goal for Single Pool (spKt/V) for 3x/week frequency of dialysis treatments?
Greater than or equal to 1.2
In Kt/V, what is K?
Clearance of Urea
What treatment factors decrease K?
Inadequate coagulation, decreased BFR, poor priming, not following P&P, patient not staying on Tx as prescribed.
What treatment factors increase K?
Increased BFR, correct DFR, correct dialyzer, correct target weight- amputation factor.
What is the goal for the urea reduction ratio (URR) lab result?
Great than or equal to 65%
What is the ‘t’ in Kt/V?
Time of dialysis session
What factors influence ‘t’?
Running prescribed Tx time, follow physician orders- encourage pt to r un entire tx. Getting off early will impact time (missing tx also impact tx time)
What is ‘V’ in Kt/V?
Volume of urea distribution/volume of pts body water in which urea is distributed
What factors influence ‘V’?
Amputation, height, sex, age, and type of access ( less efficient access reduces the volume process of a patients blood)
What is the procedure for a Post BUN lab draw?
Turn off UFR or decrease it to 50ml/hr
Decrease DFR to 300 or put in bypass
Decrease BFR to 100 ml/min
Wait 15 seconds for all access types and draw post
What are lab draw mistakes that would falsely increase Kt/V?
BFR not reduced
waiting only 5 seconds
drawing Post BUN from venous line
What are lab draw mistakes that would falsely decrease Kt/V?
Accidentally diluting pre Tx arterial BUN blood sample with saline, waiting longer than 15 seconds to draw blood sample.
