Wk. 11 - Dialysis Flashcards

What are the main indications for dialysis in acute kidney injury (AKI)?

severe metabolic disturbances, fluid overload, persistent uremia

When is dialysis typically initiated in chronic kidney disease (CKD)?

When GFR falls below 15 mL and symptoms of uremia develop.

How does osmosis work in dialysis?

Water moves from an area of low solute concentration (blood) to high solute concentration (dialysate) to remove excess fluid.

What role does diffusion play in dialysis?

Solutes like urea, creatinine, and potassium move from the blood (higher concentration) to the dialysate (lower concentration) for waste removal.

What is ultrafiltration in dialysis?

A pressure gradient forces excess fluid out of the blood through a dialysis membrane to manage fluid overload.

What are the advantages of home hemodialysis (HHD)?

Greater schedule flexibility, better blood pressure control, and improved quality of life.

What is a disadvantage of in-center hemodialysis?

Fixed schedule, travel required, and increased risk of infections & hypotension.

Why is peritoneal dialysis (PD) preferred for some patients?

It allows more flexibility, preserves residual kidney function, and has fewer dietary restrictions.

What is the best long-term vascular access for hemodialysis?

Arteriovenous (AV) fistula

What are the key nursing assessments for a hemodialysis vascular access site?

Check for patency by palpating for a "thrill" and auscultating for a "bruit."

What should be avoided on the arm with a dialysis fistula or graft?

Blood pressure measurements, blood draws, and IV access.

What are common complications of hemodialysis?

Hypotension, disequilibrium syndrome.

What are the nursing care priorities for peritoneal dialysis?

Monitor the exit site, use sterile technique, assess fluid balance, and watch for signs of infection or protein loss.

What is the most serious complication of peritoneal dialysis?

Peritonitis, characterized by cloudy effluent, abdominal pain, fever, and nausea.

Why can peritoneal dialysis cause respiratory distress?

Increased intra-abdominal pressure can restrict lung expansion.