Basic PD
What are the two types of peritoneal dialysis?
Continuous Ambulatory Peritoneal Dialysis (CAPD) and Automated Peritoneal Dialysis (APD) or CCPD
Each hour of delay in administering antibacterial therapy from the time of presentation to a hospital facility increased the risk of PD failure or death by BLANK %.
6.8%
Ability to maintain target weight. Edema Free State. Normotensive without medication.
What are two reasons the long dwell is valuable?
Middle Molecule Clearance & Phosphorus Clearance
When should the standard PET be performed?
4-12 weeks after full volume PD is achieved, stable peritoneal membrane
What is a PD Catheter?
A small, soft tube put through the wall of the abdomen into the peritoneal cavity.
Peritonitis is not a universal experience. What group of patients are most vulnerable?
Those who have already experienced a peritonitis event. CLUSTERING
Nursing Key Assessment Activities to evaluate Residual Renal Function. (Name 2)
Recent NSAIDS/Dye Exposure, Dehydration Episodes, Utilization of ACE's & ARB's, Diuretic Use, 24-hour Urine Volume
Creatinine Clearance mirrors BLANK clearance.
Phosphorus
Why do we perform the PET?
Peritoneal membrane characteristics are inherent, individualized and change over time.
What are the components of a PD exchange?
Drain, Fill, Dwell
Peritonitis Prevention Strategies (Name 2)
Retraining, Excellent Hand Hygiene, Home Visits, Catheter Replacement for Relapsing/Repeat Events, Avoid Constipation, Address Hypokalemia
Enhanced solute removal, Removal of sodium & water, Middle Molecule Clearance, and Improved BP control
A dwell time less than 90 minutes can cause what?
Sodium Sieving
What must the blood glucose be at the beginning of the PET?
What is the only type of dialysis that preserves residual renal function?
PERITONEAL DIALYSIS
Diagnosing Peritonitis (Name 2)
Must have 2 of the following: abdominal pain and/or cloudy effluent, positive culture, Dialysis effluent white cell count > 100/μL (after a dwell time of at least 2 hours), with > 50% polymorphonuclear
Key factors when evaluating the PD Prescription. (Name 2.)
Optimal Modality (CAPD vs APD), Membrane Transport Type Characteristics, Dwell Time, Dialysis Tonicity
Short dwells are critical for BLANK and BLANK.
Ultrafiltration and Small Solute Clearance
What samples are collected to perform the Standard PET?
Overnight Dwell (8-12 hours), 0, 2, and 4-hour dialysate urea, creatinine and glucose, and 2-hour serum urea, creatinine and glucose.
What are some advantages of peritoneal dialysis therapy?
Preserve residual kidney function, no needles required, independent therapy, no care partner required, daily treatment (more like the kidney), portable therapy
Two Valuable Resources for Peritonitis Prevention and Management
PD Vascular Access Care Guide & Calculate by QxMD
How can we evaluate mechanical issues impacting the PD catheter?
Dwell time and the number of exchanges should be determined by BLANK and BLANK.
Membrane Transport Type & Clearance Goals
When do we perform a MODIFIED PET?
When we suspect peritoneal membrane insufficiency. This is the diagnostic test for membrane failure.