NURC 424 Exam 3 Chapter 46 - Dialysis &
Kidney Transplant Study Guide
Dialysis - Answer Substances move from the blood through semipermeable membrane
into dialysate. Corrects fluid/electrolyte imbalance and removes waste. Required when
uremia is no longer able to Tx w/ other measures and when GFR < 15
Peritoneal Dialysis (PD) - Answer Dialysis solution is placed into the peritoneal space. 3
phases of "exchange": inflow, dwell, drain. Inflow last for perscriebed amout of time
(30-50min). Advantages: less complicated, fewer dietary restrictions, less training time
required, less cardiovascular stress.
PD Catheter Placement - Answer Cath placed through anterior ABD wall. Anchored w/
Dacron cuff. Tip of cath is in parenteral cavity. Have pt empty bowel and bladder prior to
avoid possible puncture and contamination.
PD Dialysis Solutions - Answer Dextrose is most common, Icodextrin and amino acids
are alternatives.
Automated Peritoneal Dialysis - Answer Most common, pts are able to dialyses while
they sleep. automated cycler is used to deliver the dialysate.
Continuous Ambulatory Peritoneal Dialysis - Answer Performed qfew hours while awake
- exchange of 2 L of dialysate 4 times daily, with dwell times of approximately 4 hours.
Complications of PD - Exit Site Infection - Answer d/t infections of peritoneal cath
Complications of PD - Peritonitis - Answer d/t contamination or progression of exit
site/tunnel infection. S/Sx rebound tenderness, ABD pain, ↑
WBC > 100, nausea, hyperactive bowel sounds, diarrhea, ABD distension. Can cause
protein loss of up to 40g/day
Complications of PD - Hernias - Answer d/t ↑ intraabdominal pressure secondary to
dialysate infusion
Complications of PD - Lower Back Problems - Answer d/t increased intraabdominal
pressure. Tx w/ orthopedic binders and exercise.
Complications of PD - Bleeding - Answer Normal to be pink for the first few days.
Menstruation and ovulation can cause bleeding also.
Complications of PD - Pulmonary Complications - Answer Atelectasis, PNA, bronchitis.
Longer dwell times increase risk. Encourage deep breathing, frequent repositioning,
and HOB elevation.
Complications of PD - Protein Loss - Answer Expected loss = 0.5g/L of dialysate
drainage, but can be as high as 20g/day, more with peritonitis.
Kidney Transplant Study Guide
Dialysis - Answer Substances move from the blood through semipermeable membrane
into dialysate. Corrects fluid/electrolyte imbalance and removes waste. Required when
uremia is no longer able to Tx w/ other measures and when GFR < 15
Peritoneal Dialysis (PD) - Answer Dialysis solution is placed into the peritoneal space. 3
phases of "exchange": inflow, dwell, drain. Inflow last for perscriebed amout of time
(30-50min). Advantages: less complicated, fewer dietary restrictions, less training time
required, less cardiovascular stress.
PD Catheter Placement - Answer Cath placed through anterior ABD wall. Anchored w/
Dacron cuff. Tip of cath is in parenteral cavity. Have pt empty bowel and bladder prior to
avoid possible puncture and contamination.
PD Dialysis Solutions - Answer Dextrose is most common, Icodextrin and amino acids
are alternatives.
Automated Peritoneal Dialysis - Answer Most common, pts are able to dialyses while
they sleep. automated cycler is used to deliver the dialysate.
Continuous Ambulatory Peritoneal Dialysis - Answer Performed qfew hours while awake
- exchange of 2 L of dialysate 4 times daily, with dwell times of approximately 4 hours.
Complications of PD - Exit Site Infection - Answer d/t infections of peritoneal cath
Complications of PD - Peritonitis - Answer d/t contamination or progression of exit
site/tunnel infection. S/Sx rebound tenderness, ABD pain, ↑
WBC > 100, nausea, hyperactive bowel sounds, diarrhea, ABD distension. Can cause
protein loss of up to 40g/day
Complications of PD - Hernias - Answer d/t ↑ intraabdominal pressure secondary to
dialysate infusion
Complications of PD - Lower Back Problems - Answer d/t increased intraabdominal
pressure. Tx w/ orthopedic binders and exercise.
Complications of PD - Bleeding - Answer Normal to be pink for the first few days.
Menstruation and ovulation can cause bleeding also.
Complications of PD - Pulmonary Complications - Answer Atelectasis, PNA, bronchitis.
Longer dwell times increase risk. Encourage deep breathing, frequent repositioning,
and HOB elevation.
Complications of PD - Protein Loss - Answer Expected loss = 0.5g/L of dialysate
drainage, but can be as high as 20g/day, more with peritonitis.
