Download to read offline
NURSING MANAGEMENT OF PERITONEAL DIAYLSIS
- 1.
- 2. ANATOMY OF THE PERITONEUM Theperitoneum is a thin, semi-permeable membrane lining the abdominal cavity and covering the abdominal organs.
- 3. WHAT IS PERITONEALDIALYSIS ? Peritoneal Dialysis (PD) is a type of renal replacement therapy that uses the peritoneum, a thin membrane lining the abdominal cavity, to filter waste products from the blood. PD utilizes the peritoneum as a semi-permeable membrane to remove excess fluids, electrolytes, and waste products from the blood. During peritoneal dialysis, a cleansing fluid called dialysate passes through a catheter tube into peritoneal cavity. The dialysate absorbs waste products from blood vessels in the lining of the abdomen, called the peritoneum.
- 4.
- 5. TYPES OF PERITONEALDIALYSIS 1. Continuous Ambulatory Peritoneal Dialysis (CAPD) A manual, continuous process where dialysate is infused into the abdominal cavity and exchanged several times a day. Characteristics : ▪ Manual exchanges (4 - 6 times/day). ▪ Continuous dialysis (24/7). ▪ Uses a bag or container for dialysate. ▪ Requires patient or caregiver to perform exchanges. 2.Automated Peritoneal Dialysis (APD) An automated process where a machine (cycler) performs exchanges at night while the patient sleeps. It is also called continuous cycling peritoneal dialysis. Characteristics : ▪ Automated exchanges (nightly, 8-12 hours). ▪ Cyclical dialysis (multiple cycles/night). ▪ Uses a machine (cycler) for exchanges. ▪ Requires minimal patient intervention during exchanges
- 7. INDICATIONS 1. End-Stage RenalDisease (ESRD 2. Acute Kidney Injury (AKIX 3. Chronic Kidney Disease (CKD) Stage 5X 4. Congestive Heart Failure (CHF 5. Hepatorenal SyndromeX 6. Nephrotic Syndrome 7. Refactory Hypertension.
- 8. CONTRAINDICATIONS 1. Severe abdominaladhesions or scarring. 2. Recent abdominal surgery or trauma. 3. Active peritonitis or tuberculosis. 4. Hernias (umbilical, inguinal, or abdominal). 5. Obesity (BMI >40). 6. Severe respiratory disease
- 9. REQUIREMENTS • Peritoneal dialysiscatheter. • Dialysate bags or containers. • Dialysate solution (various strengths). • Transfer set (connects catheter to dialysate bag). • Drainage bag (for effluent removal). • Scale (for weighing dialysate and effluent). • Thermometer (for temperature monitoring). • Blood pressure monitor. • Glucose meter (for monitoring blood sugar).
- 10. Patient Preparation: 1. Explainprocedure and purpose to patient. 2. Obtain an informed consent. 3. Reassurance patient to ally anxiety and fear. 4. Allow the client to void before catheter insertion. 5. Institute abdominal skin preparation. 6. Document the client's weight before the dialysis. 7. Take baseline vital signs. 8. During and after the procedure. 9. Monitor the level of electrolytes. 10. Obtain samples of return dialysate for culture. 11. Compare the client's weight before and after the procedure. 12. Monitor the vital signs every 30 minutes and report any deviations. 13. Provide proper positioning for the dialysate to return from the peritoneal cavity. Place t patient in semi-Fowler's position. 14. Observe for abdominal pain and fever which can indicate peritonitis. 15. Maintain adequate nutrition and adhere to any prescribed diet. (Increase protein intake to replace lost one during the procedure).
- 11. COMPLICATIONS ▪ Peritonitis ▪ Exit-siteinfections ▪ Tunnel infections ▪ Hernias ▪ Fluid overload
- 12.
- 13. GROUP MEMBERS 1. DeborahAdjoa Ofori : NMCTSRGN230012. 2. Princess Fiadzo : NMCTSRGN230016. 3. Princess Akweley Sonne : NMCTSRGN230019. 4. Entsie Ellen Akosua : NMCTSRGN230036. 5. Christiana Naa Ayeley Okoe : NMCTSRGN230059. 6. Afenya Samuel Kekeli : NMCTSRGN230092. 7. Serwaa Gyasi : NMCTSRGN230095. 8. Fiagbe Francisca : NMCTSRGN230116.