Podcast
Questions and Answers
What is the primary reason for instilling antibiotic solution into the bladder during a kidney transplant surgery?
What is the primary reason for instilling antibiotic solution into the bladder during a kidney transplant surgery?
What is the significance of rapid revascularization in a kidney transplant procedure?
What is the significance of rapid revascularization in a kidney transplant procedure?
What is the purpose of tunneling the donor ureter through the bladder submucosa during a kidney transplant procedure?
What is the purpose of tunneling the donor ureter through the bladder submucosa during a kidney transplant procedure?
What is the sequence of events during a kidney transplant procedure involving two sisters?
What is the sequence of events during a kidney transplant procedure involving two sisters?
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What is the purpose of placing a urinary catheter into the bladder during a kidney transplant procedure?
What is the purpose of placing a urinary catheter into the bladder during a kidney transplant procedure?
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What is the significance of releasing the clamps during a kidney transplant procedure?
What is the significance of releasing the clamps during a kidney transplant procedure?
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What is the primary purpose of assessing fluid status in a hemodialysis patient?
What is the primary purpose of assessing fluid status in a hemodialysis patient?
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What is the primary function of the dialysate delivery and monitoring system?
What is the primary function of the dialysate delivery and monitoring system?
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What is the purpose of adding heparin to the hemodialysis system?
What is the purpose of adding heparin to the hemodialysis system?
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What is the primary purpose of assessing the patient's temperature before hemodialysis treatment?
What is the primary purpose of assessing the patient's temperature before hemodialysis treatment?
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What is the purpose of flushing the dialyzer and blood lines with saline solution after the hemodialysis treatment?
What is the purpose of flushing the dialyzer and blood lines with saline solution after the hemodialysis treatment?
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What assessment data should be obtained before initiating hemodialysis treatment for a patient like K.W.?
What assessment data should be obtained before initiating hemodialysis treatment for a patient like K.W.?
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What is the primary consideration for determining the infusion of replacement fluid in CRRT?
What is the primary consideration for determining the infusion of replacement fluid in CRRT?
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What is the primary mechanism of solute removal in CVVHDF?
What is the primary mechanism of solute removal in CVVHDF?
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What is a key advantage of CRRT compared to HD in terms of hemodynamic stability?
What is a key advantage of CRRT compared to HD in terms of hemodynamic stability?
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What is a key difference between CRRT and HD in terms of monitoring requirements?
What is a key difference between CRRT and HD in terms of monitoring requirements?
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What is a key advantage of CRRT compared to HD in terms of equipment requirements?
What is a key advantage of CRRT compared to HD in terms of equipment requirements?
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What is the primary difference between CVVHD and CVVHDF in terms of dialysis fluid?
What is the primary difference between CVVHD and CVVHDF in terms of dialysis fluid?
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What is the primary goal of immunosuppressive therapy in kidney transplant recipients?
What is the primary goal of immunosuppressive therapy in kidney transplant recipients?
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Why is it essential to monitor urine output in kidney transplant recipients?
Why is it essential to monitor urine output in kidney transplant recipients?
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What type of rejection occurs minutes to hours after transplant?
What type of rejection occurs minutes to hours after transplant?
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What is the consequence of chronic rejection in kidney transplant recipients?
What is the consequence of chronic rejection in kidney transplant recipients?
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What is a priority teaching need for C.L. before discharge?
What is a priority teaching need for C.L. before discharge?
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Why is it essential to assess for hyponatremia and hypokalemia in kidney transplant recipients?
Why is it essential to assess for hyponatremia and hypokalemia in kidney transplant recipients?
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What is a possible complication of a kidney transplant due to recurrence of the original kidney disease?
What is a possible complication of a kidney transplant due to recurrence of the original kidney disease?
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What is a corticosteroid-related complication that can affect the eyes?
What is a corticosteroid-related complication that can affect the eyes?
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What is the most likely cause of a patient's symptoms six days after a kidney transplant from a deceased donor?
What is the most likely cause of a patient's symptoms six days after a kidney transplant from a deceased donor?
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Which of the following is NOT a complication of a kidney transplant?
Which of the following is NOT a complication of a kidney transplant?
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What is a possible complication of corticosteroids in kidney transplant patients?
What is a possible complication of corticosteroids in kidney transplant patients?
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Which of the following is a complication of a kidney transplant that can be treated with IV antibiotics?
Which of the following is a complication of a kidney transplant that can be treated with IV antibiotics?
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Study Notes
Hemodialysis Procedure
- Before HD treatment, assess fluid status by checking weight, BP, peripheral edema, heart, and lung sounds
- Assess vascular access and temperature
- Monitor vital signs (VS) every 30-60 minutes
- Two large-bore needles are placed in the fistula or graft: one for pulling blood from circulation to the HD machine and one for returning dialyzed blood to the patient
Hemodialysis System Components
- Dialysate delivery and monitoring system is used
- Heparin is added to prevent clotting
Hemodialysis Procedure (Termination)
- The dialyzer/blood lines are primed with saline solution to eliminate air
- The procedure is terminated by flushing with saline to return all blood to the patient
- Needles are removed, and firm pressure is applied
Case Study: Hemodialysis Readiness
- Before starting HD treatment, assess:
- Fluid status (weight, BP, peripheral edema, heart and lung sounds)
- Vascular access
- Temperature
- VS every 30-60 minutes
Kidney Transplant Surgical Procedure
- The transplant recipient undergoes:
- Urinary catheter placement into the bladder
- Antibiotic solution instillation to decrease infection risk
- Crescent-shaped incision
- The donor kidney is anastomosed to the recipient's iliac artery and vein
- The transplant recipient's ureter is tunneled through the bladder submucosa (ureteroneocystotomy)
Continuous Renal Replacement Therapy (CRRT)
- Infusion of replacement fluid is determined by the degree of fluid and electrolyte imbalance
- Anticoagulants are needed to prevent blood clotting
- Customized to patient's needs
Continual Renal Replacement Therapy (CRRT) vs Hemodialysis (HD)
- CRRT is continuous rather than intermittent
- Fluid volume can be removed over days versus hours
- Solute removal is by convection (no dialysate required) in addition to osmosis and diffusion
- Less hemodynamic instability
Kidney Transplant Nursing Management
- Postoperative care:
- Dehydration must be avoided
- Assess for hyponatremia/hypokalemia
- Monitor urine output and maintain catheter patency
- Patient education: signs and symptoms of rejection, infection, and surgical complications; follow-up care
Kidney Transplant Immunosuppressive Therapy
- Goals:
- Adequately suppress immune response to prevent rejection
- Maintain sufficient immunity to prevent overwhelming infection
Kidney Transplant Complications
- Rejection types:
- Hyperacute (antibody-mediated, humoral) rejection
- Acute rejection
- Chronic rejection
- Recurrence of original kidney disease:
- Glomerulonephritis
- IgA nephropathy
- Diabetic nephropathy
- Focal segmental sclerosis
- Corticosteroid-related complications:
- Aseptic necrosis of joints
- Peptic ulcer disease
- Diabetes
- Cataracts
- Dyslipidemia
- Infections
- Cancers
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Description
Test your knowledge of the hemodialysis procedure, including assessment and preparation steps before and during treatment. This quiz covers the essential steps and considerations for healthcare professionals involved in hemodialysis care.