Dialysis and care of person with dialysis .pptx

Dialysis and care of person with dialysis .pptx

• 1.
  DIALYSIS Presented by- RishikaRawat [RN/RM]
• 2.
  DIALYSIS  Dialysis isthe procedure used to correct fluid and electrolyte imbalances and to remove waste products in renal failure.  DO: waste removal and fluid removal.  Do Not - correct the endocrine functions of the kidney.  How long does hemodialysis take? Hemodialysis usually is done two to three times a week. Each treatment lasts from 2 to 4 hours.
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  Dialysis Haemodialysis Peritoneal dialysis.
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  .  HEMODIALYSIS Hemo simplymeans "blood". Dialysis meaning "to pass through. It removes nitrogenous waste products excess fluid and electrolyte from the blood by means of artificial kidney --Nearly 90% of all dialysis patients receives hemodialysis.  PERITONEAL DIALYSIS It removes nitrogenous waste products, excess fluids and electrolytes from the blood by means of peritoneal membrane --Approximately 10-15% patients are receiving peritoneal dialysis
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  DIALYZER  Dialyzer arehollow-fiber artificial kidneys that contain thousands of tiny tubules that act as semipermeable membranes.  The blood flows through the tubules, while a solution (the dialysate) circulates around the tubules.  The exchange of wastes from the blood to the dialysate occurs through the semipermeable membrane of the tubules
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  . PHYSIOLOGICAL PRINCIPLES ONDIALYSIS  OSMOSIS  DIFFUSION  ULTRA FILTRATION  Diffusion- movement of solutes from an are greater concentration to an area of Iow concentration. In renal failure urea, creatinine, uric acid, and electrolytes(Potassium, phosphate), move from the blood to the dialysate with the net effect of lowering their concentration in the blood. But WBC's, RBC's and other contents within the blood are too large to diffuse across the membrane.
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  .  OSMOSIS The movementof fluid from an area of lesser to an area of greater concentration of solutes. Glucose is added to the dialyzing solution and creates an osmotic gradient across the membrane to remove excess fluid from the blood.  Ultra filtration Ultra filtration is defined as water moving under high pressure to an area of lower pressure. This process is much more efficient at water removal than osmosis. Ultra filtration is accomplished by applying negative pressure or a suctioning force to the dialysis membrane
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  Vascular Access ofHemodialysis  Access to the patient's vascular system must be established to allow blood to be removed, cleansed, and returned to the patient's vascular system. Several types of access are available.  Fistula  Graft
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  Peritoneal Dialysis  Peritonealmembrane, serves as the semi permeable membrane for dialysis. It involves repeated cycle of instilling dialyzing solution into the peritoneal cavity through a catheter into it.
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  COMPLICATIONS  HEMODIALYSIS o Hypotension oMuscles cramps o Clot formation o Septicemia o Hepatitis  PERITONEAL DIALYSISE o peritonitis o abdominal pain o Hernia o Low back pain o Protein loss o Atelectasis o pneumonia
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  Nursing care (BeforeDialysis)  Informed Consent  Explanation the procedure  Ask the patient to void  Check Wt., vitals (BP) at the beginning and at least every 30 minutes.  Check for cannula and fistula for patency and palpate for the thrill and auscultation.
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  Care During Dialysis Regular observation of complications.  Check and record vitals 15 minutes.  Serve foods as patient's interest (not for hypotensive prone patients)  Each treatment lasts from 2 to 4 hours.  During treatment, Pt. is allowed to read, write, sleep, talk, or watch TV.  Back care and diversional therapy  Inform to Dr. if complications.
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  Care after Dialysis Check and record vital signs, Wt. after HD and total filtration .  Record the condition of the patient.  Medications as ordered (if)Explain about the care necessary after Hemodialysis.  Inform the family and patient of date for next dialysis . Send the patient home or ward