How PD Works
The bidirectional movement of solutes across a membrane from an area of higher solute concentration to an area of lower solute concentration
What is diffusion?
A set of specific
practices and procedures performed under carefully controlled conditions with the goal of minimizing contamination by pathogens.
What is aseptic technique?
Patient Reported Outcomes Measure, Residual Kidney Function, Fluid Status, Nutrition Status, and Removal of Toxins.
What are the key elements of goal directed care?
This can be caused by mechanical blockage d/t closed clamps, kinks, blot clots, fibrin, or omental wrap.
What is a catheter obstruction?
These are usually made of polyester Dacron and allow tissue in-growth and help prevent leaks and the migration of bacteria.
What are cuffs of the PD catheter?
This occurs when the solutes dissolved in a solvent (water) are small enough to pass through the membrane and are dragged along with the solvent and cross over to the other side.
Most effective
and least expensive way of preventing and controlling infections.
What is hand hygiene?
Ultrafiltration goals should be targets to achieve this.
What is euvolemia?
This is the preferred stool pattern for PD patients.
What is type 4? Like a sausage or snake, smooth and soft.
This should be visible to the patient, laterally directed or downward directed.
What is the exit site?
This determines the rate of clearance.
What is solute size?
Strength of the solution, Expiration Date, Amount and Leaks.
What is S.E.A.L.?
Enhanced total solute clearance, Removal of sodium and water, Middle molecule clearance including beta-2-microglobulin, Improved phosphate control, Improved blood pressure control, Lower prevalence of left ventricular hypertrophy, better nutritional status
What are the benefits of residual kidney function?
This usually occurs at the initiation of PD therapy and usually resolves after a few months on therapy.
What is drain pain?
This will help to reduce trauma to the pd catheter exit site.
What is immobilization?
This drives transcapillary ultrafiltration and water removal in PD.
What is osmosis?
Performing this step in an exchange before filling the abdomen has been shown to decrease peritonitis risk from contamination for both CAPD and APD.
What is flush?
Assess for initial prescription, Individualize the prescription based on Volume of Distribution of Urea, Residual Kidney Function, and Peritoneal Membrane Type, Monitor the patient regularly and adjust the prescription as required.
What is A.I.M.? (prescription management process)
This is the leading cause of transfer for patients from PD to HD and is not a universal experience for PD patients.
What is peritonitis?
What are when exit site assessments should be performed?
This solution is associated with slow sustained ultrafiltration throughout the long dwell.
What is Extraneal? (Icodextrin)
This provides an easy means for patients to differentiate between the different strengths of many of its dialysis solutions.
This describes how the peritoneal membrane transports solutes and fluids in different patients across the peritoneal membrane.
What is the PET test?
Things we can do to positively impact peritonitis rates. (Name 3)
What is PD training and retraining, hand hygiene, connectology, preventing bowel source of infections, antibiotic prophylaxis before procedures, treatment of contaminations, exit site care, and continuous quality improvement?
Subjective, Tunnel, External Exit Site, Crust, Drainage, Visible Sinus
What are exit site assessment parameters?