Diuretic Phase
What is the Diuretic Phase and what should I monitor?
2nd phase of AKI and monitor for electrolyte imbalances
What is the purpose of dialysis?
to correct fluid and electrolyte imbalance and eliminate waste products
What pulses should be assessed? Distal or proximal pulses to graft?
Distal
Name 5 risk factors
Feminine hygiene sprays or douching
Urinary Stasis
Indwelling Catheters
Elderly
Diabetes
What are other names for kidney stones?
Renal calculi and Nephrolithiasis
What labs are affected? Do they increase or decrease?
BUN and Creatine is decreased
What is the name of the solution used to remove toxic waste?
Dialysate
Avoid taking bp, drawing blood, inserting IV's in affected site
Name 5 Risk factors
Sexual intercourse
Use of diaphragms for contraception
Pregnancy
Bubble Baths
Post menopausal
What type of disorder is PKD?
Genetic disorder
What happens to GFR?
GFR is recovering
How much solution do you insert in peritoneal cavity?
2-3L
What do you protect fistulas/grafts from?
protect from trauma or infection
What occurs when pts. use feminine hygiene or douching?
Alters vaginal flori
Name risk factors for kidney stones
Metabolic Climate Dietary Obesity Lifestyle Poor fluid intake Genetic Hypercalcemia Immobility
How long does diuretic phase last?
1-3 weeks
How long should the solution sit in peritoneal cavity?
20-30 min or up to 8hrs
What should you notify HCP regarding fistulas/grafts?
Notify HCP if there are signs of clotting or infection
What meds should be given to treat kidney stones?
Opioids, NSAIDS, a-adrenergic blockers
What is their urine output? Which electrolytes should be monitored?
- increase of urine output 1-3L or up to 5L
- monitor for electrolyte imbalances (hyponatremia, hypovolemia, hypotension, hypokalemia, dehydration)
What are the steps to peritoneal dialysis?
1. Inflow (fill) 2-3 L of Dialysate solution over 10 min.
2. Dwell in 20-30 min. or +8hrs
3. Drain the waste products 15-30 min.
Cycle repeats
What should I assess with fistulas/grafts?
Auscultate for bruit
Palpate for thrill
Assess the pulses & neurovascular status distal to the graft
What 2 things should a nurse do with pt. that has kidney stones?
Manage the acute attack (treat pain, infection, and/or obstruction)
Evaluate cause of stone formation and prevent further development