NUR198 EXAM 4
Clinical manifestations of CKD
Poor wound healing
Dry, itchy, pale yellow appearance
ED, immunosupp.
Nausea
confusion
tremors
HTN
HF
CKD respiratory presetation
kussmaul breathing
crackles
pink, frothy sputum
SOB
Lab testing with CKD
Low specific gravity
increased creatinine levels, BUN
Increased serum K, MG, Phosphate
Decreased Ca
Decreased Na
Nursing considerations with CKD
Monitor weight daily
limit protein rich foods (PROTEIN INCREASES BUN)
Limit Na, K, Phosphate
,Fluid restriction
monitor for infections
CKD diet
High carbs
Medium fats
Low protein
CKD Tx
Calcitrol (Vit D to absorb calcium)
calcium carbonate for hypocalcemia, maintain bones
hemodialysis/peritoneal dialysis to cleanse blood of toxins, maintain
acid/base as well as electrolyte
Hemodialysis
removes blood though AV shunt (Fistula), cleanses blood, redirects
back to circulation
Main reasons for dialysis
chronic renal failure causing volume overload, hyperkalemia,
metabolic acidosis
dialysis complications
clotting of AV fistula site
infection
disequilibrium
Hypotension
anemia
Peritoneal Dialysis
Dialysis in which peritoneal cavity pumped full of hypertonic solution.
Fluid left in cavity, then drained
, dwell time
length of time the dialysis solution stays in the peritoneal cavity
during peritoneal dialysis
Peritoneal Dialysis indications
olde clients
poor mobility
transportation issues
unable to tolerate anticoagulants
vascular access is difficult
HF/HTN
Peritoneal Dialysis: CAPD
Continuous Ambulatory Peritoneal Dialysis
Daily dialysate exchanges performed manually throughout the day
Peritoneal dialysis: CCPD
Continuous cycle peritoneal dialysis
exchange occurs at night via machine while client is sleeping,
dialysate left in all day, emptied following night
Peritoneal Dialysis Nursing Procedure
Pre- check pre weight, BUN, creatinine, electrolytes, education
intra- obtain vitals during first exchange, monitor blood sugar.
Post- record outflow amount, color, clarity, record amount
Peritoneal dialysis complications
Peritonitis
local infection at access site
Loss of body protein
Increased serum glucose, lipids
blockage/dislodgement of dialysis catheter
Clinical manifestations of CKD
Poor wound healing
Dry, itchy, pale yellow appearance
ED, immunosupp.
Nausea
confusion
tremors
HTN
HF
CKD respiratory presetation
kussmaul breathing
crackles
pink, frothy sputum
SOB
Lab testing with CKD
Low specific gravity
increased creatinine levels, BUN
Increased serum K, MG, Phosphate
Decreased Ca
Decreased Na
Nursing considerations with CKD
Monitor weight daily
limit protein rich foods (PROTEIN INCREASES BUN)
Limit Na, K, Phosphate
,Fluid restriction
monitor for infections
CKD diet
High carbs
Medium fats
Low protein
CKD Tx
Calcitrol (Vit D to absorb calcium)
calcium carbonate for hypocalcemia, maintain bones
hemodialysis/peritoneal dialysis to cleanse blood of toxins, maintain
acid/base as well as electrolyte
Hemodialysis
removes blood though AV shunt (Fistula), cleanses blood, redirects
back to circulation
Main reasons for dialysis
chronic renal failure causing volume overload, hyperkalemia,
metabolic acidosis
dialysis complications
clotting of AV fistula site
infection
disequilibrium
Hypotension
anemia
Peritoneal Dialysis
Dialysis in which peritoneal cavity pumped full of hypertonic solution.
Fluid left in cavity, then drained
, dwell time
length of time the dialysis solution stays in the peritoneal cavity
during peritoneal dialysis
Peritoneal Dialysis indications
olde clients
poor mobility
transportation issues
unable to tolerate anticoagulants
vascular access is difficult
HF/HTN
Peritoneal Dialysis: CAPD
Continuous Ambulatory Peritoneal Dialysis
Daily dialysate exchanges performed manually throughout the day
Peritoneal dialysis: CCPD
Continuous cycle peritoneal dialysis
exchange occurs at night via machine while client is sleeping,
dialysate left in all day, emptied following night
Peritoneal Dialysis Nursing Procedure
Pre- check pre weight, BUN, creatinine, electrolytes, education
intra- obtain vitals during first exchange, monitor blood sugar.
Post- record outflow amount, color, clarity, record amount
Peritoneal dialysis complications
Peritonitis
local infection at access site
Loss of body protein
Increased serum glucose, lipids
blockage/dislodgement of dialysis catheter
