VIANZON, REYNALDO JR.

, M
BSN IV
NCM 106
PERITONEAL DIALYSIS
Definition
Peritoneal Dialysis is a way to remove waste products from your blood
when your kidneys can no longer do the job adequately. During
peritoneal dialysis, blood vessels in your abdominal lining (peritoneum)
fill in for your kidneys, with the help of a fluid (dialysate) that flows into
and out of the peritoneal space.
Peritoneal dialysis differs from hemodialysis, a more commonly used
blood-filtering procedure. With peritoneal dialysis, you can give
yourself treatments at home, at work or while traveling. You may be
able to use fewer medications and eat a less restrictive diet than you
can with hemodialysis.
Purpose
- Aid in removal of toxic substances and metabolic wastes.
- Establish electrolyte balance.
- Remove excesses body fluid.
- Assist in regulating the fluid balance of the body.
- Control blood pressure.
- Control severe, intractable heart failure when diuretics no longer
promote
elimination of water and sodium.
Risk
- Bleeding at the access site
- Low blood pressure
- Irregular heartbeat
- Infection
- Nausea
- Air bubbles in the blood
Procedure
Preparing the client
Explain the procedures and assist patient in obtaining signed
consent.
Record baseline vital sigs, weight and serum electrolyte level
Evaluate of the abdomen for placement of the catheter
Encourage patient to empty the bladder and bowel to reduce risk
of puncture on internal organs.
Preparing the equipment

 Consult the physician to determine the concentration of dialysate

to be used and medications to be added.
Before adding the medications, the dialysate is warmed to body
temperature to prevent discomfort and abdominal pain, and to
dilate vessels of peritoneum to increase urea clearance.
DO NOT SOAK BAG OF SOLUTION IN WARM WATER AND
USE OF MICROWAVE TO HEAT THE FLUID.
Filled tubing with prepared dialysate to reduce amt. of air
entering the catheter & peritoneal cavity.
Inserting the catheter
The catheter is inserted in the operating room or radiology suite.
Catheters for long-term use are usually soft and flexible and
made of silicone with radiopaque strip.
3 sections of catheter
a. Intraperitoneal section
b. Subcutaneous section
c. External section
Although the catheter can be used right away, it is best to wait
10 to 14 days after placement before dialysis is performed; this
allows the catheter site to heal.
Nursing Management
1. Meet psychosocial needs
2. Discuss basic principles of peritoneal dialysis
3. Demonstrate catheter and exit site care
4. Demonstrate measurement of vital signs & weight measurement
5. Discuss monitoring & management of fluid balance.
6. Discuss aseptic technique
7. Discuss complications of peritoneal dialysis: prevention,
recognition & management of complication
8. Demonstrate procedure for adding medications to dialysis
solution
9. Discuss dietary restrictions
10.
Describe plan of follow up care
11.
Demonstrate maintenance of home dialysis
records
HEMODIALYSIS
Definition
In hemodialysis, a machine filters wastes, salts and fluid from your
blood when your kidneys are no longer healthy enough to do this work
adequately. Hemodialysis is the most common way to treat advanced

kidney failure. The procedure can help you carry on an active life
despite failing kidneys.
Hemodialysis requires you to follow a strict treatment schedule, take
medications regularly and, usually, make changes in your diet.