Question

A 56 year old patient is being admitted to the hospital for peritoneal dialysis.

a. What are principals for administering peritoneal dialysis?

b. What is involved with the exchange of fluids?

A patient with chronic kidney disease will be doing peritoneal dialysis at home.

a. Discuss the education that the nurse needs to provide the patient and family in order for them to be safe and competent?

Answer 1

Ans) a. During peritoneal dialysis: The dialysate flows into your abdomen and stays there for a prescribed period of time (dwell time) — usually four to six hours. Dextrose in the dialysate helps filter waste, chemicals and extra fluid in your blood from tiny blood vessels in the lining of your abdominal cavity.

b. As wastes fill the solution, it cleans the blood less efficiently. Another way to increase the amount of fluid and waste drawn into the peritoneal cavity is to use dialysis solution with a higher concentration of dextrose. Dialysis solution comes in 1.5 percent, 2.5 percent, and 4.25 percent dextrose concentrations.

a. Family caregivers are critical partners in the plan of care for patients with chronic illnesses.

- Nurses should be concerned with several issues that affect patient safety and quality of care as the reliance on family caregiving grows. Improvement can be obtained through communication and caregiver support to strengthen caregiver competency and teach caregivers new skills that will enhance patient safety.

- Previous interventions and studies have shown improved caregiver outcomes when nurses are involved, but more research is needed. There is more to be learned about the effect of family caregivers on patient outcomes and areas of concern for patient safety. Nurses continue to play an important role in helping family caregivers become more confident and competent providers as they engage in the health care process.

Ways to take control:

• Choose a healthcare team that specializes in your stage of kidney disease.
• Don’t smoke.
• Exercise.
• Take medications as prescribed by your doctor.
• Eat right by limiting foods that are high in protein, saturated fats, phosphorus, potassium and sodium, all of which can put extra strain on your kidneys. If you need help managing a kidney diet, use DaVita Diet HelperTM, a tool that makes it easy to plan meals, track your nutrients and more.
• Know more about medications when you have renal disease. Some prescription and over-the-counter medicines and herbal supplements can be very harmful. Check with your doctor or pharmacist before taking any new medications.