Hemodialysis

indications

mimics normal kidney function, continued hyperkalemia, acidotic, fluid overload

what does hemodialysis do

blood volume is pulled into a machine that pulls out excess fluid or electrolytes in the blood then sends the clean blood back in via another tubing

AV fistula

surgically connecting artery and vein forming a mega vessel (condiut)

what is needed for an AV fistula

2 needles 16 gauge, one to pull out blood and another to return

what to avoid if a patient has a AV fistula and what could happen if a nurse does it

no BP or sticks in the arm, could cause it to burst and bleed

AV graft

surgically inserted synthetic tube to connect artery and vein, sewn into the vasculature

quinton catheter

reversible, inserted in internal jugular/subclavian greater tahn superior vena cava, basically temporary CVL

interventions

little hypotension is expected, monitor along with dialysis nurse (typically runs 3-4 hours), post op

postop interventions

monitor distal pulses, monitor for bleeding and infection, monitor BP, labs, continuous EKG

what should the pulse feel and sound like if a patient has a fistula

swish brewey sound, thrill vibration feeling

complications

dialysis disequilibrium syndrome, severe hypotension and tachycardia, bleeding, infection, arrhythmias

cause of dialysis disequilibrium syndrome

unknown, thought to be related to cerebral edema

dialysis disequilibrium syndrome s/s

altered mental status, headache, n/v, restlessness, seizure, coma

dialysis disequilibrium syndrome interventions

slow the flow down, call provider

why give heparin during dialysis

to keep the machine from clotting

why are arrhythmias a complication

due to shifting electrolytes