Dialysis Flashcards

(36 cards)

1
Q

What is the purpose of dialysis?

A

To preform the filtration tasks of the kidneys artificially

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2
Q

What are the indications for dialysis?

A

A – Acidosis
E – Electrolyte abnormalities
I – Intoxication
O – Oedema
U – Uraemia symptoms

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3
Q

What type of acidosis requires dialysis?

A

Severe and not responding to treatment

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4
Q

What electrolyte abnormalities require dialysis?

A

Severe and unresponsive hyperkalaemia

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5
Q

What type of oedema requires dialysis?

A

Severe and unresponsive pulmonary oedema

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6
Q

What is the most common form of renal replacement therapy?

A

Haemodialysis

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7
Q

What does haemodialysis involve?

A

Regular filtration of the blood through a dialysis machine in hospital

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8
Q

How often do patients require haemodialysis a week?

A

3 times per week

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9
Q

How long does each session of haemodialysis last?

A

3-5 hours

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10
Q

What are the options for access to blood supply for patients undergoing haemodialysis?

A

Tunnelled cuffed catheter
Arterio-venous fistula

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11
Q

What is a AV fistula?

A

An artificial connection between an artery to a vein

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12
Q

When does an AV fistula need to be created prior to starting haemodialysis?

A

8 weeks

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13
Q

Where is the AV fistula for haemodialysis usually created?

A

Radio-cephalic
Brachio-cephalic

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14
Q

What is a tunnelled cuff catheter?

A

A tube inserted into the subclavian or jugular vein with a tip that sits in the superior vena cava or right atrium.

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15
Q

What is peritoneal dialysis?

A

Renal replacement therapy where the filtration occurs within the patient’s abdomen

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16
Q

What is used as the filtration membrane in peritoneal dialysis?

A

The peritoneal membrane

17
Q

How is the dialysis solution administered in peritoneal dialysis?

A

It is injected into the abdominal cavity through a permanent catheter

18
Q

What is the dialysis solution made up of for peritoneal dialysis?

A

High dextrose concentration

19
Q

What happens in peritoneal dialysis?

A

The high dextrose concentration of the solution draws waste products from the blood into the abdominal cavity across the peritoneum

20
Q

What happens after dwell time in peritoneal dialysis?

A

The dialysis solution is drained removing waste products and exchanged for new dialysis solution

21
Q

What are the two different types of peritoneal dialysis?

A

Continuous ambulatory peritoneal dialysis (CAPD)
Automated peritoneal dialysis (APD)

22
Q

What is continuous ambulatory peritoneal dialysis (CAPD)?

A

There is dialysis solution in the abdomen at all times

23
Q

What is Automated peritoneal dialysis (APD)?

A

A dialysis machine fills and drains the abdomen while the patient is sleeping

24
Q

How often is fluid changed and how long does APD take?

A

3-5 exchanges over 8-10 hours each night

25
How often is the fluid in CAPD changed?
2 litres changed 4 times a day
26
What is the main complication of peritoneal dialysis?
Bacterial peritonitis
27
What bacterial usually causes bacterial peritonitis?
Staphylococcus epidermidis.
28
How does a patient with bacterial peritonitis present?
Abdominal pain Fever Cloudy dialysis bag
29
What are the possible complications of haemodialysis?
Cardiovascular disease- endocarditis and arrhythmias Disequilibration syndrome
30
What are the possible complications of an AV fistula
STEAL syndrome Stenosis Aneurysm High output heart failure
31
What is STEAL syndrome?
Inadequate blood flow to the limb distal to the AV fistula
32
What does steal syndrome cause?
Diverts blood away from where it was supposed to supply and straight into the venous system
33
What does STEAL syndrome result in?
Distal limb ischaemia
34
What is Disequilibration syndrome?
Acute cerebral oedema due to rapid extraction of osmotically active substances
35
How can an AV fistula result in high output hear failure?
Blood flows quickly from arterial to the venous system through the fistula There is rapid return of blood to the heart Increases the pre-load in the heart
36
What is the most common cause of death on dialysis?
Ischaemic heart disease