Review the passive process of osmosis - CORRECT ANSWER -dissolved substances,
such as urea and creatinine, diffuse across the membrane from an area of
... [Show More] greater
concentration (blood) to an area of lesser concentration (dialysate)
-water molecules move across the membrane by osmosis to the solution that contains
fewer water molecules
Describe how dialysate is formulation - CORRECT ANSWER -it is formulated with
varying concentrations of *dextrose* or *sodium* to produce an osmotic gradient
>this pulls excess water from the circulatory system
All forms of dialysis make use of the principles of _____ and _______ to: - CORRECT
ANSWER -osmosis
-diffusion
>to remove waste products and excess fluid from the blood
A semipermeable membrane is the: - CORRECT ANSWER -dialysis circuit between the
blood and the dialysate
Venous Catheters - CORRECT ANSWER -dual-lumen catheters inserted into large
central veins (femoral, int jug, subclav) are used for acutely ill patients who need:
>hemodialysis
>continuous venovenous hemofiltration (CVVH)
>continuous venovenous hemofiltration with dialysis (CVVH/D)
>acute dialysis
>chronic dialysis (who are waiting for permanent access [av fistula or graft] to mature)
-tunneled dual-lumen often used as permanent access i
Nursing Interventions for the Patient with Dialysis Vascular Access:
>dual-lumen venous catheter - CORRECT ANSWER -if in upper torso, such as
subclavian or internal jugular position, verify central line catheter placement
radiographically before use
-do not inject IV fluids or medication into the catheter; both lumens of the catheter may
be filled with concentrated heparin
-do not unclamp the catheter unless preparing for dialysis therapy; this can cause blood
to fill the lumen and clot
-maintain sterile technique in handling vascular access
-observe catheter exit site for signs of inflammation or catheter kinking
Nursing care for catheters used for dialysis - CORRECT ANSWER -care must be taken
to avoid accidental slippage and dislodgement during hemodialysis
>they are usually secured with sutures and sterile dressing
-central venous catheters can be used for up to 3-4 weeks
>used tunneled dialysis catheters to reduce line-associated blood infections if
hemodialysis will last longer than 3 weeks
-pressure applied to puncture site after removal
-maintain catheter patency
Arteriovenous Fistulas - CORRECT ANSWER -anastomoses an artery and a vein,
creating a fistula or artificial opening between them
-benefits: avoidance of inserting a foreign object into body; infection is reduced
-maintaining blood flow through fistula is priority [Show Less]