Ultrafiltration
Fluid pushed through the semipermeable membrane
Convection
Solutes dragged across semipermeable membrane along with
... [Show More] fluid
Diffusion
Particles move from area of high concentration to low
Osmosis
Fluid moves from area of low to high concentration
What are the kidneys' excretory functions?
To normalize electrolytes, remove wastes, provide fluid and nutrient balance
What are the kidneys' endocrine functions?
Renin secretion, erythropoietin secretion, vitamin D activation
What is the function of the acid concentrate?
Provides the concentration gradient for diffusion
What is the function of bicarbonate the dialysate solution?
Buffer the acid concentrate
What is the function of bicarbonate when it diffuses into the patient's blood?
Normalizes body pH
How do we replace normal excretory kidney functions?
Normalizes electrolytes, provide fluid balance through ultrafiltration
How do we replace normal endocrine kidney functions?
Provide medications
Outline the treatment goals for a patient with chronic kidney disease (CKD)
-slowing the progression of ckd
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects of ckd on patients' lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
What are the most common causes for CKD in the USA?
Diabetes
Hypotension
Polycystic Kidney Disease
Why is it important to know what caused your patient's CKD?
So the nurse and PCT can inquire about possible problems during data collection and assessment
Signs and Symptoms of fluid imbalance
Hypertension
Edema
Shortness of breath
What does hypertension lead to?
Left Ventricular Hypertrophy
Why is sodium balance important?
Leads to volume expansion- increased CO- increased peripheral vascular resistance- increased BP
Signs and symptoms of Hyperkalemia
>6.5 mEq symptoms: extreme muscle weakness, abnormal heart rhythm, and possible cardiac arrest
Signs and symptoms of Hypokalemia
<3.5 mEq symptoms: fatigue, muscle weakness, paralysis, and respiratory failure, cardiac instability, arrhythmias, cardiac arrest
Why are dialysis patients anemic?
The lifespan of their RBC is 60 days or approx 1/2 of normal 120 days
Primary cause: lack of the hormone erythropoietin (epo)
Secondary cause: inadequate iron stores, inadequate dialysis, malnutrition, blood loss during treatment
How can you prevent contributing to lower hemoglobin levels and blood loss in dialysis patients?
Ensure Epogen dose is correct and administered, rinse back blood completely, avoid repeat lab draws
What is pericarditis?
Inflammation of the membrane (pericardial sac) around the heart
What is included in its treatment?
decrease or stop heparin
give more frequent dialysis
Systemic effects of CKD
Dry, itchy skin -> what do you do?
use hyper-fatty soaps and lotions caution patient re; safety at home, provide emotional support, control diabetes and phosphorus
Systemic effects of CKD
Peripheral Neuropathy (nerve pain in extremities)
-> what do you do?
monitor patient for changes in motor function, decreased strength in legs, C/O restless legs, burning feet.
advise patient not to walk barefoot, have good foot care practices [Show Less]