Dialysis
when do we use renal replacement therapy?
- when the kidneys can no longer remove wastes, maintain electrolytes or regulate fluid balance
why is diet so important for patients on hemodialysis?
- diet is important for patients on hemodialysis because of the effects uremia
- accumulation of metabolic end products can cause symptoms of uremia to worsen
what are some functions of the kidneys?
- urine formation
- excretion of waste products
- regulation of electrolytes
- regulation of acid-base balance
- control of water balance
- control of blood pressure
- renal clearance - regulation of RBC production- synthesis of vitamin D to active form
- secretion of prostaglandins
How often will a patient on hemodialysis receive treatment?
typically three times a week, with each session lasting between 3-5 hours in length
what are the types of dialysis?
- hemodialysis
- CCRT
- peritoneal dialysis
why should you limit your intake of salt and sodium during dialysis?
this will make you drink more fluids, which can lead to fluid accumulation which can further lead to weight gain, heart failure, and/or pulmonary edema
what can happen to our kidneys as we age?
- GFR decreases
- more susceptible to acute or chronic kidney injury
- older adults more prone to hypernatremia and fluid volume deficit
- urinary incontinence, inability to empty bladder
what are some things that the nurse should be monitoring for a hospitalized patient on dialysis?
- lab values
- blood pressure
- IV site
- s/sx of uremia
- cardiac and respiratory complications
what happens during dialysis?
- blood is diverted from the patient to a machine via the use of a blood pump to the dialyzer where toxins can be filtered out and the blood can be returned to the patient.
when you are on a renal diet, what electrolytes/elements should you limit?
sodium, potassium, phosphorus
what do we do if dialysis doesn't work?
the patient will likely have to get a kidney transplant
what sound do we assess for over the venous access site?
bruit or "thrill"