In Through the Outflow
Your patient id taking a longer time than usual to drain. You notice that they are lying supine in bed. What is the first step you might take to troubleshoot?
What is reposition?
A patient arrives at the hospital with a diagnosis of peritonitis. What might the nephrologist want done to the transfer set?
What is change the transfer set out for a new one?
You have a patient with 4 hour dwells in teh hospital. Over several days, you become concerned for fluid overload. What suggestions could be made to the nephrologist?
What is shorten the dwell time and/or increase the dextrose % in the dialysate to pull more fluid?
What is the name for the fluid we put into the patient's abdomen?
What is dialysate?
Antibiotics are ordered in one of the dwells. What considerations must you take?
What is making sure the bag is not left on the warmer more than 4 hours and making sure the dwell time is at least 6 hours?
You have repositioned your patient, raised the bed, and they are still taking a long time to completely drain. What is something you might expect to find when assessing the effluent?
What is fibrin?
What symptoms might a patient exhibit with peritonitis?
What is pain, fever, elevated white blood cell count, and cloudy effluent?
Patient has been in the hospital for several days. Because you are an awesome PD nurse, you take their dry weight after they are empty at about the same time every day. You notice they weigh less, and we have been getting good UF. They are ortho + and dizzy when standing. What changes might the nephrologist consider?
What is the name of the fluid that comes out of the patient?
What is effluent?
Your PD patient has not had a BM in a couple of days. What do you do?
Constipation can be an emergency for a PD patient. You must get patient to agree to aggressive Bowel regimen.
What should be done with the catheter tubing in between exchanges?
What is secure the line to prevent iritation at the exit site?
You are assessing the exit site and notice warmth, redness, and pain that was not there on prior assessments. What do you do?
What is contact the nephrologist right away?
What is the first thing you do with the catheter when you are beginning treatment?
What is clean the outside of the catheter and tubing with alcohol wipe for 15 seconds?
What is the name for the fluid "taken off" in addition to the volume of the original dialysate?
What is Ultrafiltrate or UF for short?
What might the nephrologist order in the next bag if fibrin is found?
What is heparin?
You are starting an exchange and you just scanned your bag, what should you do right now to make your life easier for the next exchange?
What is order the next bag?
When draining your patient you notice the effluent is cloudy, what should you do?
What is, contact the nephrologist right away and if this is new, save the effluent to send to the lab?
Your patient has been on PD for two months. They complain of pain during the exchange. What do you do?
What is the amount of time that the fluid remains in the peritoneal space before it is changed out again called?
What is dwell time?
You have not performed PD in a while. You are feeling a little "rusty". What is your first order of business?
What is talking to my charge nurse and looking at tip sheets?
What is alteplase?
What is the main cause of peritonitis?
Your patient has abeen sluggish to fill and drain the last few exchanges. You've tried troubleshooting but have had no luck. They are already also on heparin. What other factor might you look at as a potential source of this problem?
What is the date of their last bowel movement?
What is amount of fluid that the patient "kept" called?
What is retained fluid?
Wipe down clamps after each use, get rid of old bags (don't let them stack up on toilet), periodically wipe down high touch areas and patient tray table with gray wipes, restock caps in room?