2023-11-06T00:48:21+03:00[Europe/Moscow] en true <p>more difficult to manipulate solute/fluid removal, blood doesn't have intimate contact w/ dialysis membrane, can't regulate blood flow to peritoneal membrane</p>, <p>dialysate volume, dwell time, no. of exchanges, concentration of dextrose/solutes </p>, <p>through abdominal muscles; distal end falls into pelvic gutter</p>, <p>2-6 weeks after placement </p>, <p>overnight exchanges only; no dwell during the day</p>, <p>long dwell during the day; machine does several, short dwells/exchanges overnight </p>, <p>glucose; icodextrin</p>, <p>at least 1.7</p>, <p>urine production &lt; 100ml/day; &gt;=1.7</p>, <p>catheter obstruction, catheter kinking, excessive catheter motion at exit site, inflow pain </p>, <p>1 occurrence every 2 years</p>, <p>elevated dialysate WBC &gt;100/mm + &gt;=50% polymorphonuclear neutrophils</p>, <p>abdominal pain, cloudy effluent </p>, <p>s. epidermidis </p>, <p>a</p>, <p>intraperitoneal administration </p>, <p>penicillin, FQ, 1st cephs</p>, <p>urine output &gt;100 mL, drug renally eliminated; 25%</p>, <p>immediate removal of catheter; continue oral treatment for 10 days </p>, <p>intranasal/topical mupirocin, rifampin </p>, <p>CV stability, less pulmonary stress, preservation of residual kidney function, lifestyle independence, no vascular access required </p>, <p>infection risk, daily administration, protein/amino acid losses, malnutrition, dextrose overload </p> flashcards
Peritoneal Dialysis

Peritoneal Dialysis

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  • more difficult to manipulate solute/fluid removal, blood doesn't have intimate contact w/ dialysis membrane, can't regulate blood flow to peritoneal membrane

    Why is Peritoneal Dialysis less efficient than Hemodialysis? (3)

  • dialysate volume, dwell time, no. of exchanges, concentration of dextrose/solutes

    How can we enhance Peritoneal Dialysis? (4)

  • through abdominal muscles; distal end falls into pelvic gutter

    Where do we place the PD access device?

  • 2-6 weeks after placement

    When can we administer a large volume of dialysate?

  • overnight exchanges only; no dwell during the day

    Explain the term "Dry day".

  • long dwell during the day; machine does several, short dwells/exchanges overnight

    Explain the term "Wet day".

  • glucose; icodextrin

    _______ & ________ create a hyperosmolar environment that results in the

    osmotic pull of water into the peritoneal cavity. *Ultrafiltration

  • at least 1.7

    What must the Kt/V be?

  • urine production < 100ml/day; >=1.7

    What residual renal function results in patients requiring a higher Kt/V?

    What is the new Kt/V?

  • catheter obstruction, catheter kinking, excessive catheter motion at exit site, inflow pain

    Why can mechanical failures occur in PD access?

  • 1 occurrence every 2 years

    How common is Peritonitis?

  • elevated dialysate WBC >100/mm + >=50% polymorphonuclear neutrophils

    What is Peritonitis? (2)

  • abdominal pain, cloudy effluent

    When should we suspect a patient has Peritonitis? (2)

  • s. epidermidis

    What is the most common organism implicated in Peritonitis?

  • a

    Which type of bacteria is more common in Peritonitis?

    a) Gm (+)

    b) Gm (-)

    c) Atypical

  • intraperitoneal administration

    What type of peritonitis treatment is preferred?

  • penicillin, FQ, 1st cephs

    What are the ABs used in continuous treatment? (3)

  • urine output >100 mL, drug renally eliminated; 25%

    When can we increase the dose of ABs?(2)

    How much can we increase the dose by?

  • immediate removal of catheter; continue oral treatment for 10 days

    How is fungal peritonitis treated? (2)

  • intranasal/topical mupirocin, rifampin

    How can we prevent Staph. Aureus- Peritonitis? (2)

  • CV stability, less pulmonary stress, preservation of residual kidney function, lifestyle independence, no vascular access required

    What are the advantages of Peritoneal Dialysis? (5)

  • infection risk, daily administration, protein/amino acid losses, malnutrition, dextrose overload

    What are the disadvantages of Peritoneal Dialysis? (5)