Preprocedure NIs for Hemodialysis
- Check for informed consent.
- Assess patency of fistula (bruit, palpable thrill, distal pulses, & circulation.
- Assess vital signs, lab values (BUN, serum creatinine, electrolytes, Hct), and weight.
- Discuss w/ do meds that need to be held until after
Intraprocedure NIs for Hemodialysis
- Monitor for circuit clotting, air bubbles in blood tubing, temp of dialysate (37.8 c / 100 F), regulation of the ultrafiltration.
- Monitor vital signs and coagulation studies. Monitor for bleeding.
- Have protamine sulfate ready to reverse heparin if n
Postprocedure NIs for Hemodialysis
- Monitor vital signs and lab values (Decreases are expected in BP and labs).
- Compare pre and post weights (1 L = 1 kg or 2.2 lbs)
- Assess for complications, bleeding, and signs of disequilibrium syndrome or hypovolemia.
- Avoid invasive procedures for
How do you check a grafted fistula for patency?
thrill or bruit
Foods high in folate are .....
beans and green vegetables
Protein is _____ during each dialysis exchange.
lost
Use _____ during cannulation.
surgical aseptic tecnique
Disequilibrium syndrome is caused by ......
too rapid a decrease of BUN and circulating fluid volume.
Disequilibrium may result in ......
cerebral edema and increased intracranial pressure.
Early signs of disequilibrium are .....
nausea, vomiting, change in LOC, seizures, and agitation.
Peritoneal dialysis is the _____ and is indicated for clients who .....
treatment of choice for the older adult
are unable to tolerate anticoagulation; have difficulty with vascular access; have chronic infections or are unstable.
In Peritoneal dialysis, the color of dialysate is expected to be ______ and the amount of outflow is expected to ......
clear, light yellow
equal or exceed the amount of dialysate inflow.
In Peritoneal dialysis you ______ the dialysate prior to inserting and ______ of the catheter insertion site.
warm
maintain surgical asepsis
In Peritoneal dialysis, the outflow bag is kept _____ than the client's abdomen in order to ______.
lower
drain by gravity and prevent reflux
Complications of Peritoneal dialysis can include:
- infection at the access site
- protein loss
- hyperglycemia and hyperlipidemia
- poor dialysate inflow or outflow (constipation is common cause)
Dialysate contains _____ and is a _____ solution.
glucose
hypertonic