The pressure within the superior vena cava,

reflecting the pressure under which the blood

is returned to the superior vena cava and
right atrium.

Determine by the vascular tone, blood

volume, and the ability of the right heart to
receive and pump blood.
Excellent way to evaluate child’s
fluid volume status.
1. Identify the client and explain the procedure.

2. Check for the IV fluid (name, amount, color)

3. Check drip chamber if half full.
4. Check drop factor. (should be KVO)
5. Check tubing for kinks and check insertion
site for complications.
6. Check manometer if working.

7. Check the patients CVP. (normal CVP should

be 2 to 12mmHg)
8. Check again after 15 minutes. The client’s
position should be the same to prevent
inaccuracy of the measurement.

9. Instruct client to report any

complications.
10. Wash hands.
11. Document.
In measuring CVP, the nurse makes certain
that the client is relaxed at the time of the
measurement.

Straining, coughing, or any other activity

that increase the intrathoracic pressure
causes falsely high measurements.

 Monitor for any Complications

1. Pneumothorax 5. Fluid overload

2. Phlebitis 6. Sepsis

3. Air embolism 7. Dysrrhythmia

4. Pulmonary 8. Microelectric shock

embolism
Normal CVP – 2 to 12mmhg
Drop in CVP indicates;
Rise in CVP indicates;

• A decrease in • Increase in blood

circulating volume volume due to a
which may result from sudden shift in fluid
fluid imbalance balance
• Hemorrhage or severe • IVF infusion
vasodilation • Renal failure or
• Pooling of blood in the Sodium and H2O
extremities with limited retention
venous return
A process used for patient who
are actually ill and require
short term dialysis or for
patient with end-stage renal
disease who require long term
or permanent therapy
To extract toxic nitrogenous
substance from the blood
To remove excess water
To prevent death
1.Verify the doctor’s order
2.Check for the consent form

3.Prepare the client

-Level of alertness of the patient

-Understanding of the patient

about the procedure
4.Check the vital signs of the patient

5.Prepare the materials to be use

6.Wash hands

7.Wear gloves

8.Put tourniquet to the arm of the patient

9.Clean the insertion site
10.Insert the needle
 11.Secure it with micropore tape
12.Remove the tourniquet
13.Start the hemodialysis

When the hemodialysis is done

14.Remove the needle

15.Check for any complication

16.Assess the comfortability of the patient

17.Check the vital signs

18.Wash hands
19.Documentation
Check for redness, swelling, and irritation.

Instruct the client to inform the nurse if any signs

and symptoms are present.

Instruct client to give pressure to the insertion site

if there is bleeding.
The choice procedure for acute
conditions
Is relatively easy to learn , and safe
to perform
Requires minimum equipment and
specially trained nurses
1. Continuous Ambulatory Peritoneal Dialysis:
-> Left in place for 4 to 8hours

2. Continuous Cycle Peritoneal Dialysis:

-> Same as CAPD but different in that it
requires a peritoneal cycling machine
-> 3 cycles done at night and 1 cycle with
an 8hours dwell done in the monitoring
3. Intermittent Peritoneal Dialysis:
-> 10 to 14hours
-> 3 to 4 times a week with peritoneal cycling
machine
To remove toxic substance and
metabolic wastes
To establish normal fluid balance
(by removing excessive fluids)
To restore electrolyte balance
1. Verify the doctor’s order

2. Check the consent form signed by the

patient or family of the patient.

3. Prepare the materials.

4. Identify the client & explain the procedure.

5. Prepare the client
> level of consciousness
> previous experience with dialysis
> assess the understanding of the patient
> relieve patient’s anxiety

6. Check the VS, weight, and serum electrolyte

level are recorded.

7. Ask the patient to void first before the

procedure.
8. Wear Gloves.

9. Insertion of the catheter.

> Clean the site
> Stab wound is in the lower abdomen
(3 to 5cm below the umbilicus)

10. Infused the diasylate into the peritoneal

cavity.

*Diasylate is allowed to flow freely into the

peritoneal cavity.
*5 to 10mins. is usually required for infusion
of 2L of fluid.

11. After infusion of solution, close roller

clamp.

12. Unclamped the draining tube.

* usually draining is completed after 10
to 30 mins. (colorless)
13. Health Teaching.
> instruct the client to notify the nurse
if the draining bottle is almost full.
> instruct the client to notify the nurse
if there is swelling or irritation in the
site.

14. Wash Hands.

15. Document the procedure.

Promote patient comfort during procedure

Maintain peritoneal dialysis fluid infusion

and drainage

Monitor changes in fluid and electrolyte

status, weight changes, vital signs, and
intake and output records

Monitor for any complications