Kidney Function
Risk Factors
Peritoneum
Process
Care of the Patient
100

What is considered the "work horse" of the kidney?

The nephron

1 million per kidney.  

# of functioning nephrons decreases with age.

10% for every 10 years of age after 40

100

Name 2 leading causes of CKD

Diabetes and Hypertension

Others include:  Lupus, exposure to nephrotoxins, recovery from AKI, older age, family history, reduced renal mass, smoking

100

Name 3 advantages of PD

Slower, gentler

Minimal disruption of daily activities

Less restrictive diet

Done at home

Avoids systemic effects of heparin

Fewer adverse physiological consequences

100

What are the phases of PD?

Drain

Fill

Dwell

100

Name 3 basic nursing care interventions for the patient receiving PD

Hand hygiene

Warming the dialysate

Cover site with a dressing during hospitalization

Immobilize the catheter

Exit site care

Ensuring patient and/or family is performing exchanges properly for the hospital.

200

Name 3 functions of the kidney

Filtering 

Fluid removal

Balance Body Chemistry

Control BP

Stimulate RBC Production

Promote Bone Strength & Prevent Blood Vessel Hardening

200

Name 3 Nephrotoxins

NSAIDs

Antibiotics

CT dye

200

What are the transport mechanisms utilized in PD?

Diffusion

Osmosis

Ultrafiltration

200

Why is dextrose content in the dialysate important?

The amount of dextrose in the solution will determine the amount of fluid that is removed. 

200

Who would add medications to the dialysate

Pharmacy.  

Most common meds added:  

Antibiotics, heparin, insulin

300

Three things filtered through the kidney

Sodium, Potassium, Waste Products

Monitors phosphorus, calcium, and vitamin D

300

Name 2 things that can occur when the kidneys don't work well

Uremia

Fluid Overload

Hyperkalemia

Hyper/hypotension

Anemia

Decreased bone density

300

What are 2 contraindications to a patient opting for PD?

Abdominal surgeries

Hernias

Excessive obesity

Preexisting vertebral disease

Severe COPD

Rapid treatment is needed

Peritonitis

300

What should be included in the patient assessment prior to an exchange?

Vital signs

Dry weight

Labs

Nutritional status

Exit site assessment


300

Where would you document the PD catheter

LDA (Lines, Drains, and Airways)

400

Which is a better indicator of kidney filtration:  Serum Creatinine or Glomerular Filtration Rate?

GFR-Glomerular Filtration Rate

400

These ethnic backgrounds have a higher incidence of CKD

Black Americans

Native Americans

400

Name 2 common complications of PD

Peritonitis

Weight gain

Weakening of the abdominal muscle

Hyperglycemia

Hyper/Hypotension

Damage to the catheter

Fibrin shreds = Clotting

Difficulty draining/filling

400

Is PD an Aseptic or Sterile Procedure?

Tricky One!  

Strict aseptic technique while maintaining sterility of the peritoneal dialysis catheter tip

400

How often is routine exit site assessment and care completed?

At least daily.

An exit site score of = to or >4 can signify infection.

500

At what stage kidney disease will the patient be preparing for Dialysis Therapy?

Stage 4.

Stage 5 the patient will be on renal replacement therapy of some kind.

500

Not including HTN and DM, name a modifiable risk factor for chronic kidney disease

Autoimmune disease

Lupus

Exposure to Nephro-toxic drugs

500

Why are bowel habits and menses important items to discuss with your patient?

Constipation can cause poor filling and draining. 

Female's effluent may have a bloody tinge due to menses.

500

What is SEAL?

Strength

Expiration

Amount

Leakage

500

What instances would you contact the LIP/Physician/Nephrologist?

Exit site score > or = to 4

Cloudy, bloody, or presence of fibrin the the effluent.

Slow draining/filling

Pain with draining/filling

Inability to instill the prescribed amount of dialysate