Managing Dialysis Patients

Course overview

Objectives List common signs and symptoms associated with renal compromise or failure Describe the process of dialysis and its various forms Explain the different shunts used in renal dialysis patients Content 1 Hemodialysis a Shunt b Fistula c Graft d Blood filtered through dialysate 2 Peritoneal Dialysis 3 Special Considerations for Hemodialysis Patients a Obtaining blood pressure b IV site placement and blood draws 4 Complications and Adverse Effects of Dialysis a Hypotension b Muscle cramps c Nausea and vomiting d Disequilibrium syndrome e Hemorrhage especially from access site f Air embolism g Myocardial ischemia h Infection at access site i Electrolyte imbalance 5 Missed Dialysis Treatment a Hyperkalemia with associated ECG changes b Weakness c Pulmonary edema d Uremic frost Management for a Patient with Acute Renal Conditions Chronic Renal Conditions with Acute Exacerbations Dialysis Problems or End Stage Renal Disease 1 Management a Airway breathing and circulation support ventilation intubate if necessary b Stop bleeding from shunt as needed c IV restrict fluids or administer fluids based on patient condition d Pharmacological interventions III Urinary System Conditions A Urinary Retention Pathophysiology incidence and causes 1 Assessment Findings and Symptoms a Unable to urinate b Bladder enlargement or distention c Lower abdominal pain d Delirium especially in elderly patients 2 Management a Primarily supportive care b Transport c IV keep vein open if abdominal pain d Insert catheter if approved by local medical director B Urinary Tract Infection Pathophysiology incidence and causes 1 Urinary bladder infection cystitis 2 Pyelonephritis 3 Assessment Findings and Symptoms a Burning sensation or pain with urination b Increased urgency and frequency of urination c Cloudy or rust colored urine d Unusual or foul odor to urine e Fever in pyelonephritis f Back or flank pain in pyelonephritis g Blood in urine h Suprapubic abdominal pain 4 Management a Primarily supportive care IV fluids if febrile or abdominal pain present b Transport C Renal Calculi Kidney Stones Pathophysiology incidence and causes 1 Assessment Findings and Symptoms a Severe flank or back pain b Abdominal pain c Pain radiating to pelvis groin or genitals d Increased urgency of urination e Painful urination f Blood in urine g Fever h Pale clammy skin 2 Management