Peritoneal Dialysis

Subject: Medical and Surgical Nursing I (Theory)

Overview

By employing the peritoneal membrane, a filter that allows fluids and dissolved compounds (such as electrolytes, urea, glucose, albumin, and other tiny molecules) from the blood to be exchanged, peritoneal dialysis is able to remove waste and surplus fluid. It is recommended for fluid overload that is resistant to diuretics, uremic convulsion, persistent dyspnea, vomiting, and restlessness, among other conditions. It is not recommended for patients with a history of multiple abdominal surgeries, severe abdominal pathology, recurrent abdominal wall or inguinal hernias, etc. reports of nausea, dizziness, and rising thirst. may be a sign of hyperosmolar syndrome and hypovolemia. Watch out for infection symptoms like cloudy drainage and fever as well as, rarely, bleeding. The presence of cloudy effluent may indicate peritoneal infection.

Peritoneal Dialysis

Dialysis is the artificial process of eliminating fluid and waste from the body, a task typically carried out by the kidneys. Hemodialysis and peritoneal dialysis are the two forms of dialysis. By using the peritoneal membrane, a filter that allows fluids and dissolved substances (such as electrolytes, urea, glucose, albumin, and other small molecules) from the blood to be exchanged, peritoneal dialysis is able to remove waste and excess fluid.

Indication

  • Fluid overload not responding to diuretics.
  • Uremic convulsion.
  • Persistent dyspnea, vomiting and restlessness.
  • Signs of pericarditis, pericardial effusion and pericardial friction rub.

Contraindication

  • History of multiple abdominal surgical procedures or severe abdominal pathology.
  • Recurrent abdominal wall or inguinal hernias.
  • Excessive obesity with large abdominal wall and fat deposits.
  • Pre-existing vertebral diseases
  • Severe obstructive pulmonary diseases.

Nursing Management

  • Measure and keep track of all bodily fluids, such as diarrhea, nasogastric output, and wound drainage.
  • Take note of reports of nausea, dizziness, and rising thirst. Could be a sign of hyperosmolar syndrome and hypovolemia.
  • While sitting or lying down, keep an eye on your pulse. Seen jugular pulsation at a level.
  • Examine the mucous membranes, the turgor of the skin, the peripheral pulses, and the capillary refill as Dehydration is indicated by dry mucous membranes, poor skin turgor, diminished pulses, and capillary refill, which calls for increased intake and adjustments to the dialysate's strength.
  • Follow-up on laboratory tests as directed: glucose and sodium levels in the blood.
  • Keep up one's nutritional state. Offer vitamin supplements together with a diet rich in calories, low in protein, low in salt, and low in potassium.
  • Observe your breathing effort and pace. In case of dyspnea, lower infusion rate.
  • Take note of the kind, volume, and color of secretions.
  • Raise the patient's chair seat or raise the head of the bed.
  • Encourage coughing and deep breathing exercises.
  • Watch out for infection symptoms like cloudy drainage and fever as well as, rarely, bleeding. The presence of cloudy effluent may indicate peritoneal infection.

 References

  • books.google.com/books?isbn=0826108288
  • backuperhard.weebly.com/blog/previous/17
  • Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
  • nurseslabs.com/6-peritoneal-dialysis-nursing-care-plans/
  • quizlet.com/140750533/renal-principles-of-dialysis-flash-cards/
  • timebackuper.weebly.com/blog/archives/04-2016/8
  • encyclopedia.com › Medicine
Things to remember
  • The peritoneal membrane, the lining of the abdomen, is used in peritoneal dialysis to remove waste and extra fluid.
  • Pericardial effusion, pericardial friction rub, and other pericarditis symptoms are indicators.
  • Strongly contraindicated in severe obstructive pulmonary diseases.
  • While sitting or lying down, keep an eye on your pulse. Note the jugular pulse intensity.
  • Follow-up on laboratory tests as directed:
  • glucose and salt levels in the blood.
  • Raise patient's head of bed or ask them to get into a chair.
  • Encourage coughing and deep breathing exercises.
  • Offer vitamin supplements together with a diet rich in calories, low in protein, low in salt, and low in potassium.
Questions and Answers

Dialysis is the process of eliminating fluid and waste from the body artificially, a task typically carried out by the kidneys. Hemodialysis and peritoneal dialysis are the two forms of dialysis. By using the peritoneal membrane, a filter that allows fluids and dissolved substances (such as electrolytes, urea, glucose, albumin, and other small molecules) from the blood to be exchanged, peritoneal dialysis is able to remove waste and excess fluid.

Indication:

  • Diuretics do not relieve fluid retention.
  • Involuntary urination
  • Persistent vomiting, dyspnea, and restlessness
  • Pericardial effusion, pericardial friction rub, and pericarditis symptoms.

Contraindication:

  • History of serious abdominal pathology or repeated abdominal surgeries.
  • Inguinal hernias or recurrent abdominal wall hernias.
  • Excessive obesity characterized by fat deposits and a thick abdominal wall.
  • Existing spinal problems
  • Severe pulmonary obstructive diseases.

Nursing management:

  • Measure and keep track of all body fluids, such as diarrhea, nasogastric output, and wound drainage.
  • Take note of reports of nausea, dizziness, and rising thirst. Could be a sign of hyperosmolar syndrome and hypovolemia.
  • While sitting or lying down, keep an eye on your pulse. Note the jugular pulse intensity.
  • Examine the mucous membranes, the turgor of the skin, the peripheral pulses, and the capillary refill as Dehydration is indicated by dry mucous membranes, poor skin turgor, diminished pulses and capillary refill, which call for increased intake and adjustments to the strength of dialysate.
  • Follow-up on laboratory tests as directed:
  • glucose and sodium levels in the blood.
  • keep up one's nutritional state. Offer vitamin supplements along with a diet high in calories, low in protein, low in salt, and low in potassium.
  • Observe your breathing effort and pace. If dyspnea is present, lower the infusion rate.
  • Take note of the kind, volume, and color of secretions.
  • Raise patient's head of bed or ask them to get into a chair.
  • Encourage coughing and deep breathing exercises.
  • Watch out for infection symptoms like cloudy drainage and fever as well as, rarely, bleeding. The presence of cloudy effluent may indicate peritoneal infection.

 

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