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Presentation1 AMRESH KUSHWAHA.pptx
- 1. SEMINAR ON DIALYSIS PRESENTED BY : MR.AMRESH KUSHWAHA BSC NURSING 2ND YEAR BCON -73
- 2. CONTENT. INTRODUCTION. DEFINITION. TYPES. THERAPEUTIC EFFECT. COMPLICATION. NURSING MANAGEMENT. CONCLUSION. BIBLIOGRAPHY.
- 3. INTRODUCTION DIALYSIS(FROM GREEK DIALUWSIS MEANINGDISSOLUTION DIA MENING THROUGH AND LYSIS MENING LOOSEING OR SPLITTING ) IS A PROCESS FOR AND IS USED PRIMARILY AS AN ARTIFICIAL REPLACEMENT FOR LOST KIDNEY FUNCTION IN PEOPLE WITH RENAL FAILURE .
- 4. DEFINITION Dialysis is anartificial process used to remove water and waste substances from the blood when kidneys fail to function properly . Types of dialysis include hemodialysis, CRRT, and PD. Acute or urgent dialysis is indicated when there and increasing level of serum potassium, fluid overload, or impending pulmonary edema; increasing acidosis; pericarditis; and
- 5. TYPES OF DIALYSIS 1.HEMODIALYSIS 2. PERITONEAL DIALYSIS
- 6. Hemodialysis is usedfor patients who are acutely ill and require short-term dialysis for days to weeks until kidney function resumes and for patients with advanced CKD and ESKD who require long-term or permanent renal replacement I therapy. Hemodialysis prevents death but does not cure kidney disease and does not compensate for the loss of endocrine or metabolic activities of the kidney HEMODIALYSIS
- 8. HISTORICAL OVERVIEW. The firstartificial kidney was developed in 1943 in The Netherlands In 1960, the first successful treatment of clients with CRF was re ported. In the early years, although the technology was available, the exorbitant cost and lack of equipment re quired a stringent selection process in choosing clients for hemodialysis.
- 9. HEMODIALYSIS PROCEDURE. √. Inhemodialysis, the client's toxin-laden blood is diverted into a dialyzer cleaned. One of the vital aspects of hemodialysis is the estab lishment and maintenance of adequate blood access Without it, hemodialysis cannot be done. The major routes of access
- 10. √• external anteriovenousshunt requires surgical placement of two rubber like silicone cannulas are connected into the forearm leg. √• The two cannulas are connected to form a U shape. Blood flows from the client's artery through the shunt into the vein √• When the client is to be connected to the hemodialy. • A tube leading to the membrane compartment is con- nected to the arterial cannulas. √• Infection at the insertion site and clotting are compl cations that often necessitate moving the cannula sites con.....
- 11. DIALYZERS. Several types ofdialyzers are available. including flat plate and hollow fiber mold devices. Choice of a particular system is mostly a matter of preference. There life differences in urea and creatinine clearance gales as well as ultrafiltration rates. Many centers that peror chronic dialysis now reprocess and disinfect the it and reuse it for the same chent to reduce costs. The dialysate solution is altered to fit the client's need.
- 12. HEMODIALYSIS SCHEDULES. Hemodialysis asa treatment for CRF must be continued intermittently for the client's lifetime unless successful kidney transplanta- non is performed. A typical schedule is 3 to 4 hours of treatment 3 days per week. This schedule varies with the size of the client, the type of dialyzer used, the rate of blood Bow, the personal preference of the client,
- 13. COMPLICATIONS OF LONG-TERM HEMODIALYSIS. Inaddition to its therapeutic effects, chronic hemodialysis can cause a number of complication. • Technical problems, such as blood leaks, overheating of the dialysate solution, insufficient loss of fluid, • Hypotension or hypertension • Cardiac dysrhythmias from potassium imbalance • Air embolus •Hemorrhage resulting from heparinization with particular concern for subdural, retroperitoneal, pericardialand intraocular bleeding •Restless legs syndrome • Pyrogenic reaction
- 14. Nursing Management The nursein the dialysis unit has an important role in monitoring, supporting, assessing, and educating the patient Promoting Pharmacologic Therapy Many medications are removed from the blood during hemodialysis; therefore, dosage or timing of the medication administration may require adjustment.
- 15. Promoting Nutritional andFluid Therapy Diet is important for patients on hemodialysis because of the effects of uremia. Meeting Psychosocial Needs Patients requiring long-term hemodialysis are often concerned about the unpredictability of the illness and the quality of their lives (Wright & Wilson, 2015) Promoting Home, Community-Based, and Transitional Care equipment; adminis Educating Patients About Self-Care
- 16. Peritoneal Dialysis Peritoneal dialysisinvolves repeated cycles of instilling Alysate the peritoneal cavity, allowing time for substance exchange, and then remvoing the dialysate The procedure is useful for both ARE and CR and fire fluid electrolyte imbalances.
- 18. TYPES OF PERITONEAL DIALYSIS. Severaltypes of permeal dialysis are in use today. The most common are contious ambulatory and automated peritoneal dialysis. Continuous Ambulatory Peritoneal Dialysis (CAPD). in the continuous type of peritoneal dialysis.
- 19. Continuous Ambulatory Peritoneal Dialysis(CAPD). in the continuous type of peritoneal dialysis, 1.5 to 3.0 L dialysate is instilled into the abdomen and left in place for a prescribed period of time. The empty dialysate bag folded up and carried in a pouch or pocket until it is time to drain the dialysate.
- 20. Automated Peritoneal Dialysis, dialysisnecessitates use of a peritoneal cycling machine This method can be performed as continuous cyclic. Continuous cyclic peritoneal dialysis. In this variation there are usually three cycles at night and me cycle with an 8-hour dwell in the morning. The advantage of this procedure is that the peritoneal catheter is opened only for the on- and-off procedures,
- 21. Intermittent peritoneal dialysis. This is not a continuous dialysis procedure. Instead, dialysis is performed for 10 to 14 hours, three to four times a week by the same peritoneal cycling machine as in continuous cyclic peritoneal dialysis Hospitalized clients may be dialyzed for 24 to48 hours at a time if the are catabolic and require additional dialysis time. Nightly intermittent peritoneal dialysis. Dialysis is performed for 8 to 12 hours each night with no day time dwell.
- 22. •Peritoneal Catheter Insertion. For a client who needs peritoneal dialysis, one of several types of soft catheters is inserted through the abdominal wall and into the peritoneal cavity. Usually, the catheter is inserted in the operating room, with the client under local anesthesia, al- though it may be inserted at the client's bedside. PERITONEAL DIALYSIS PROCEDURES
- 23. •Dialysate. The dialysate isusually allowed to run into the peritoneal cavity by gravity flow. It is warmed slightly to avoid chilling the client and to dilate the peritoneal blood vessels, thus facilitating substance exchange. In an adult 21. is usually instilled, although smaller amounts may be needed at first until the client adjusts Throughout the procedure, care must be taken to prevent air from entering the peritoneal cavity.
- 24. •Preparing the Equipment •In addition to assembling the equipment for PD, the nurse consults with the physician to determine the concentration of dialysate to be used and the medications to be added. Heparin may be added to prevent fibrin formation and resultant is occlusion of the peritoneal catheter.
- 25. •Inserting the Catheter •Ideally,the peritoneal catheter is inserted in the operating room or radiology suite to maintain surgical asepsis and minimize the risk of contamination. Catheters for long-term use are usually soft and flexible and made of silicone with a radiopaque strip to permit visualization on x-ray
- 26. •Performing the Exchange PDinvolves a series of exchanges or cycles. An exchange is the entire cycle including the infusion (fill), dwell, and drainage of the dialysate.
- 27. Complication Most complications ofPD are often minor; however, several, if unattended, can have serious consequences.
- 28. CONCLUSION Dialysis involvesdiverting the blood through 'artificial kidney' machine that cleans and returns it to the body. During this process the blood is purified by two principles (i.e. diffusion and ultrafiltration) through a semipermeable membrane. This semipermeable membrane can be cellulose membrane(in case of HD) or it can be peritoneal membrane(in case of PD).
- 29. Bibliography All photos andillustrations were sourced from the public domain. AV Fistula First Initiative by CMS/Renal Networks The Arteriovenous Fistula", Konner, Nonnast Daniel, Ritz, JASN June 1, 2003 vol. 14 no. 6 1669-1680 Long Term Survival of arteriovenous fistulas in home dialysis" Lynn, Buttimore, Wells, Roake and Morton, Kidney International (2004) 65, 1890-1896“ Vascular Access for Hemodialysis", The Renal Association, Fluck and Kumwenda, 1/5/2011