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Nursing IV > Hemodialysis > Flashcards

Flashcards in Hemodialysis Deck (31)
1

advantages of an AV Fistula

permanent access, has a low infection & thrombosis risk, predictable

2

disadvantages of an AV fistula

cant use with diabetics/vascular disease, takes 3-4 months to mature before you can use it, bleeding occurs after needles are removed

3

care of fistula, DO NOTs

do not: carry heavy items on accessed arm, sleep on that arm, wear clothing or jewelry that binds that arm, no blood draws or BPs on that arm, injections into fistula or graft, no creams or lotions

4

catheter advantages

easily inserted & removed, immediate use after insertion

5

catheter disadvantages

low flow rates, high rates of infection &thrombosis, only can use for 3-4 months, poor body image

6

subcutaneous access advantages

high flow rate, low rates of infection &thrombosis,easily implanted, immediate use after insertion,

7

Advantages of Hemodialysis

efficient clearance, increased tolerance, staff is always there to help, can get to know other pts/staff

8

Disadvantages of Hemodialysis

you have to travel to & from, sessions are 2-3 times/week lasting about 3-4 hours

9

Complications of Hemodialysis

infectious disease, frequent blood transfusions due to chronic anemia (which puts you at risk for hepatitis), AIDS, hemorrhage during or immediately after due to heparin

10

If you have frequent transfusions because of chronic anemia, what disease are you at risk for with Hemodialysis?

hepatitis

11

Medications commonly held before dialysis

Antihypertensives, Vitamins,/Folic Acid, Diuretics, Narcotics (decrease BP), Morphine, Demeral, Electrolyte preparations(oral calcium/Rocal)

12

Diet for Hemodialysis

Limit Potassium, Phosphorus, fluid intake & salt

13

Why do you want to limit Phosphorus when pt is on hemodialysis?

because too much phosphorus can cause calcium to be pulled from the bones, which makes them brittle & can cause osteoporosis

14

Why do you want to limit fluid intake when pt is on hemodialysis?

it can prolong time needed for dialysis

15

Dialysis solution & how Peritoneal Dialysis works

A mixture of minerals and sugar dissolved in water that travels through the soft tube in the abdomen. the sugar draws wastes, chemicals, & extra water from the blood vessels in the peritoneal membrane into the dialysis solution

16

Dwell time

the period that dialysis solution is in the abdomen

17

Continuous Ambulatory Peritoneal Dialysis (CAPD)

blood is always being cleaned. the dialysis solution passes from a plastic bag thru the catheter & into the abdomen where it stays for hrs & is drained later

18

An exchange

solution is drained from abdomen and new solution is put into abdomen

19

How long does solution stay in abdomen with peritoneal dialysis?

4-6 hrs or more

20

Draining used dialysis solution & replacing it takes about how long? & how many times is it done a day?

30-40 mins ; 4 times a day

21

Continuous Cycler-Assisted Peritoneal Dialysis (CCPD)

uses a machine (cycler) to fill & empty abdomen 3-5 times during the night while sleeping. In morning, client fills abdomen with solution and has a dwell time of the entire day

22

When would a pt have to use both CAPD and CCPD?

If pt weighs more than 175 lbs or if the peritoneum filters waste slowly

23

Peritoneal Diet

limit salt & liquids but not as limited than those on hemodialysis, increase protein!, may have restrictions on potassium

24

Advantages of Peritoneal Dialysis

less complex, can be used with pts who have vascular access probs, no needles, diet less strict, immediate life-threatening events (hemorrage, disequilibrium syndrome) less likely to happen

25

Disadvantages of Peritoneal Dialysis

Permanent catheter, infection, need space for supplies, daily dialysis routine,

26

Complications of Peritoneal Dialysis

Peritonitis r/t contamination of solution or tubing, respiratory distress, hyperglycemia, fluid imbalances, perforation of bladder or bowel, protein loss

27

s/s of peritonitis

rigid abdomen, abdominal pain, cloudy drainage,

28

Why would respiratory distress be a complication for peritoneal dialysis

due to upward displacement of diaphram b/o increased pressure in peritoneal cavity

29

If pts experience respiratory distress with peritoneal dialysis what other things might they experience

dyspnea, atelectasis, pneumonia, bronchitis

30

why is protein a complication in peritoneal dialysis

because it is lost thru passing in dialysate fluid

31

Why is hyperglycemia a complication in peritoneal dialysis?

because sugar is added to dialysate to increase drawing power for water out of system