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Questions and Answers
What is the primary purpose of peritoneal dialysis?
What is the primary purpose of peritoneal dialysis?
Which of the following is a necessary preparation step before starting peritoneal dialysis?
Which of the following is a necessary preparation step before starting peritoneal dialysis?
What role does heparin play in the preparation for peritoneal dialysis?
What role does heparin play in the preparation for peritoneal dialysis?
How long is the typical dwell time for peritoneal dialysis to allow diffusion and osmosis?
How long is the typical dwell time for peritoneal dialysis to allow diffusion and osmosis?
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What should be done to the dialysate solution before using it for peritoneal dialysis?
What should be done to the dialysate solution before using it for peritoneal dialysis?
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Which of the following phases is NOT part of the peritoneal dialysis exchange cycle?
Which of the following phases is NOT part of the peritoneal dialysis exchange cycle?
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When draining the solution from the peritoneal cavity, what is the usual duration for completion?
When draining the solution from the peritoneal cavity, what is the usual duration for completion?
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Which type of catheter is commonly used for peritoneal dialysis?
Which type of catheter is commonly used for peritoneal dialysis?
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What is the primary reason for the removal of excess water during peritoneal dialysis?
What is the primary reason for the removal of excess water during peritoneal dialysis?
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Which complication is characterized by inflammation of the peritoneum?
Which complication is characterized by inflammation of the peritoneum?
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What should be checked daily before peritoneal dialysis?
What should be checked daily before peritoneal dialysis?
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Which of the following statements about drainage fluid is true?
Which of the following statements about drainage fluid is true?
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What technique should be used during the intra-dialysis procedure?
What technique should be used during the intra-dialysis procedure?
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What is the maximum expected protein loss in peritoneal dialysis drainage?
What is the maximum expected protein loss in peritoneal dialysis drainage?
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What is one of the possible pulmonary complications from peritoneal dialysis?
What is one of the possible pulmonary complications from peritoneal dialysis?
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During the exchange, how long should the dialysate remain in the abdomen after instillation?
During the exchange, how long should the dialysate remain in the abdomen after instillation?
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Study Notes
Peritoneal Dialysis (PD)
- Treatment for patients with severe chronic kidney disease
- Uses the patient's own peritoneal membrane as a filter
- Goals: remove waste, rebalance fluids, maintain nitrogen balance, quality of life
PD Catheter Types
- Straight Tenckhoff
- Curled Tenckhoff
- Swan-neck
- T-fluted
Preparing the Patient
- Surgeon, interventional radiologist, or nephrologist explain the procedure
- Nurse obtains signed consent for catheter insertion
- Patient empties bladder and bowel
Preparing the Equipment
- Assemble equipment
- Check physician's orders for dialysate concentration and medications
- Heparin: prevents clotting
- KCI: prevents hypokalemia
- Antibiotics: for peritonitis
- Insulin: for diabetic patients
- Warm dialysate solution to body temperature (too cold causes pain and cramping)
PD Cycle
- Three phases: inflow, dwell, drain
- Each cycle is called an exchange
Performing the Exchange
- Dialysate is infused by gravity into the peritoneal cavity
- Dwell time allows diffusion and osmosis
- Drainage is typically completed in 20-30 minutes
- Drainage fluid should be clear
- Bloody or pink drainage is normal after catheter insertion
Types of PD
- Continuous ambulatory peritoneal dialysis (CAPD)
- Automated peritoneal dialysis (APD)
- Continuous cycling peritoneal dialysis (CCPD)
- Intermittent peritoneal dialysis
- Nocturnal (nightly) intermittent peritoneal dialysis
Complications
- Peritonitis
- Leakage
- Bleeding
- Exit site infection
- Hernias
- Lower back problems (increased intraabdominal pressure)
- Pulmonary complications (atelectasis, pneumonia, bronchitis)
- Protein loss
Nursing Management - Predialysis Care
- Document vital signs (temperature, pulse, blood pressure)
- Check daily weight before dialysis
- Monitor lab values (BUN, electrolytes, creatinine, pH, hematocrit)
- Measure and record abdominal girth
- Maintain fluid and dietary restrictions
- Have the client empty their bladder before catheter insertion
- Warm the dialysate solution to body temperature
- Explain procedures and expected sensations
Nursing Management - Intra-Dialysis Care
- Use strict aseptic technique
- Add prescribed medications to the dialysate solution
- Prime tubing with solution and connect to peritoneal catheter
- Instil dialysate over 10 minutes
- Clamp tubing and allow dwell time
- Keep drainage tubing clear of kinks and secure connections
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Description
This quiz covers essential aspects of peritoneal dialysis (PD), including treatment goals, catheter types, patient preparation, and the exchange process. Understand the role of healthcare professionals and equipment involved in PD to better grasp this life-sustaining procedure for patients with chronic kidney disease.
