Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Peritoneal dialysis
Leda-peritoneal dialysis
| Question | Answer |
|---|---|
| what does peritoneal dialysis use as the filter? | it uses the peritoneal cavity and membrane as the method of dialysis |
| APD: | automated peritoneal dialysis that runs overnight |
| CAPD | manual exchanges done of peritoneal dialysis done 4x a day for 4-10 hrs. |
| where is the access catheter with PD? | in the peritoneum |
| Must continuous peritoneal dialysis be assisted: | yes |
| who does peritneal dialysis usually get ordered by? | a nephrologist |
| is peritoneal dialysis a sterile procedure? | yes, it is sterile |
| can peritoneal dialysis be done at home: | yes, it can be done independantly |
| what are the three phases of PD: | inflow, dwell, drain |
| is the fluid placed in the abdomen hypotonic or hypertonic: | hypertonic |
| what happens in PD during the dwell phase | electrolytes and uremic toxins move via diffusion across membrane into dialysate solution. Excess water moves into the solution via osmosis |
| what is drained during the drain phase of PD: | dialysate and toxins |
| If your PD exchanges are pink tinged, is that okay: | no, not unless it is one of the first few times, your pt. is having their period or ovulating |
| what must a pt. do prior to PD: | empty bowel and bladder, and weigh themselves |
| what must you do with the fluid prior to infusion: | warm it to body temperature, check for clarity, punctures etc. |
| do you need a mask to perform PD: | yes |
| is sterile technique needed for PD: | yes |
| should drain bag be above or below pt.? | below pt. and connecting tube |
| what should the infusion line be connected to: | the dialysate bag-then hang it on IV pole |
| what position should the pt. be in for PD: | supine |
| does the tubing need to be primed prior to admin: | yep |
| should clamps be closed after tubing is primed and before it is connected: | that's easy-of course |
| after the tubing is connected and unclamped, how much fluid should be instilled and drained in order to test it: | 500 mL |
| After it is tested, you put in the prescribed amount of dialysate and cthen what? | close the clamps |
| How many times should PD be performed in a day: | as many times as ordered |
| what PD is complete, what should be done first: | drain, then clamp catheter and disconnect inflow line while maintaining sterility |
| is PD efficient, | no, not really |
| is a sterile or clean dressing used following PD: | sterile |
| how often must vital signs be monitored following PD infusion | monitor every 10 minutes until stable, then every 2-4 hours |
| Monitor your patient for what s/s of peritnitis: | fever, abdominal pain, cramps, slow or cloudy dialysate drainage, vomiting, diarrhea, distention, hyperactive b.s. |
| what s/s of infection should you watch for regarding PD? | redness at site, tenderness and drainage |
| what complications can occur with PD? | infection, peritonitis, abdominal pain, bleedingg, low back discomfort, pulmonary complications, carb and lipid abnormalities, outflow issues, and protien losses |
| How is peritonitis diagnosed? | with cultures, gram stain and WBC differential |
| what are the two common causes of exit site infection: | staph, S. epidermidis (from skin flora) |
| what are the two common causes of peritonitis: | S. aureus or S. epidermidis |
| What is abdominal pain related to: | irrititation from the low pH of the dialysate solution (gets better in a few weeks) or peritonitis. Also if tip of catheter touches bowel, bladder, or peritoneum. |
| If abdominal pain is caused by catheter placement, what can be doen. | change the position of the catheter |
| If air infuses or the diasylate infuses to quickly, what could happen: | referred pain to the shoulder |
| what could an outflow problem be caused by? | a kink in the tunnel segment of catheter or a migration out of the pelvic region or a full colon. May need to be fixed by radiologic or surgical manipulation of catheter. |
| Why are hernia's a complication of PD? | because of increased abdominal pressure d/t diialysate infusion. Common in multiparous women and older men. PD can be resumed using smaller volumes if the pt. is supine |
| Lower back problems, why are they a complication of PD | increased intra-abdominal pressure. lumbosacral curvature is increased by the dialysate. |
| what can be done to help with back problems caused by PD: | a orthopedic binder and regular exercize proram for strenthening the back |
| what are some pulmonary complications experienced by PD pts | atelectasis, pneumonia and bronchitis-caused by upward displacement of the diaphram. This means less room for lungs to expand. Also, obese pts may experience more difficulty breathing |
| what can be done to relieve pulmonary complications of PD: | repositioning, deep breathing, elevation of HOB |
| what makes pulmonary complications more likely: | increased dwell time |
| protien loss occurs with PD as a complication, why? | the peritoneal membrain is permiable ot plasma proteins, amino acids and polypeptides. These can be lost in the dialysate fluid. |
| how much protien can be lost with PD a day | 4-15 g, up to 40 if there is perinoitis as the membrane becomes more permiable. Positive nitrogen balance can be maintained with enough protien intake |
| Carb and lipid abnormalities can occur as a complication of PD, whY; | dialysate glucose is absorbed via the peritoneum and can be as muhc as 100-150 g. day. This causes increased insulin secretion and this stimulates the hepatic production of trygliscerides |
| Encapsulateing sclerosing peritonitis and loss of ultrafiltration can occur with PD, why? | loss of ultrafiltration is b/c of rapid glucose absorbtion. It is unknown why encapsulating sclerosing peritonitis occurs |
| what is encapulsating sclerosing peritonitis: | development of thick fibrous membrane that sorrounds an compresses the bowel for unknown reasons. Intestinal obstruction and strangulation are common. |
| what are some advantages of PD: | short training program, less complicated, can be done independantly, costs less, less heart stress |
| what meds are common with someone recieving peritoneal dialysis: | statins for tryglycerides, aces, BB, loop diuretics, epogen, neprocaps, vit. D |
| what are some disadvantages of PD: | self image, inconvienience, 19% higher mortality rate |
| If an enema must be given to someone wiht PD, what kind should be used: | tap water |
| what kind of dietary limitations are on someone recieving PD: | limit dairy, tomatos and bananas. |
| what kind of catheter is used for PD? | silastic catheter |
| what strength of dextrose solutions are available: | 1.5,2.5 and 4.25% |
Created by:
500946117