DIALYSIS 3.pptx dialysis nursing management

Hemodialysis and peritoneal dialysis

1. DIALYSIS

2. DEFINITION Dialysis is defined as the procedure used to remove waste products and correct the fluid and electrolyte imbalances in renal failure

3. TYPES OF DIALYSIS

4. Indications Acute renal failure Chronic renal failure Poisoning Severe metabolic acidosis Fluid overload Hyperkalemia

5. Hemodialysis Hemodialysis is an efficient modality to correct fluid and Electrolyte abnormalities due to chronic kidney failure or Acute kidney injury

6. Principles of hemodialysis

7. Equipments and other requirements Vascular access using central venous catheter Temporary access : it’s established by percutaneous insertion of catheter into a large vein such as internal jugular vein or femoral vein Permanent access : construction of arteriovenous fistula permits repeated access for months to years

8. AVF AV fistula is an abnormal connection or passageway between an artery and a vein Usually the radial artery and cephalic vein are anastomosed in nondominant hand After the procedure superficial venous system of arm dilates By means of two large bore needles are inserted into the dialated venous system , blood may be obtained and passes through the dialyzer Arterial end is used for arterial flow and distal end is used for the reinfusion of dialyzed blood Healing time of av fistula – 6 to 8weeks

9. AV FISTULA

10. AV GRAFT

11. Central venous catheter

12. Procedure of hemodialysis Patient access is prepared Heparin is administered Heparin and red flows through semipermeable dialysis in one direction and dialysis solution surrounds the membrane and flows in the opposite direction. Dialysis solution consist of highly purified water to which sodium, potassium, calcium, magnesium chloride, and dextrose have been added, bicarbonate is added to achieve the proper pH Through the process of diffusion solute in the form of electrolytes, metabolic waste products acid base balance components can be removed or added to the blood. Excess water is removed from the blood (ultrafiltration). The blood is then returned to the body through patient access.

13. PROCESS OF HEMODIALYSIS

14. DIALYSIS FLUID COMPOSITION

15. COMPLICATIONS Hemodialysis disequilibrium syndrome Hypotension Dialyzer reaction Catheter lumen thrombosis Infection

16. Peritoneal dialysis

17. PERITONEAL DIALYSIS

Peritoneal dialysis (PD) is a treatment for kidney failure.

A special sterile fluid is introduced into the abdomen through a permanent tube that is placed in the peritoneal cavity.

The fluid circulates through abdomen to draw impurities from surrounding blood vessels in the peritoneum, which is then drained from the body

18. Nurses responsibility Assess vital signs (BP, pulse, respiration, temperature). Record weight (pre-dialysis weight). Check vascular access (fistula/catheter) for bruit, thrill, patency. Review lab values (electrolytes, urea, creatinine). Explain the procedure to reduce anxiety. Ensure sterile technique and equipment readiness.