Peritoneal Dialysis

Specialties Urology

Published

Specializes in Pediatrics, Geriatrics, Call Center RN.

Hi! It's been a long time since I have been on. I have started working at a LTC facility that is soon to take on a resident who get Peritoneal Dialysis. I check in with the facility. The resident will be there in the next few days, when I'm scheduled to work. I understand there is book to read while I'm there. Is there any hints or tricks that I may need to know? Thanks in advance.

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Specializes in CCU/CVU/ICU.
Hi! It's been a long time since I have been on. I have started working at a LTC facility that is soon to take on a resident who get Peritoneal Dialysis. I check in with the facility. The resident will be there in the next few days, when I'm scheduled to work. I understand there is book to read while I'm there. Is there any hints or tricks that I may need to know? Thanks in advance.

Not really any hints or tricks...but after you do a couple times it gets very easy... ;)

1) remember to always keep everything(catheter connections!) STERILE...

2)remember to DRAIN first...

3) remember to warm solution prior to initiating exchange...

these three things are more-or-less the key to it. (and learning the specific way you do I's-and-O's)

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My mom was a PD patient. Aside from the advice you already received, often times the patient/family can be a wealth of information on how THIS particular patients membrane functions!! You have NO CLUE how many times I had to BEAT OFF well meaning nephrologists who were NOT my mom's doctor :trout: . They always wanted to be too conservative with her solution strengths, and did not want to listen to me! This ALWAYS led to fluid overload, and me throwing a HISSY fit :angryfire !! Keep in mind that this patient and their family/help have been doing dialysis at home for however long, and often times have a pretty good idea on what their body needs!!

My mom NEVER used 1.75 strength, mostly 2.5 and 4.25's, but it never failed the hospitals ALWAYS wanted to use 1.75 and 2.5's.

Also if there is a cycler involved, it will be MUCH easier for you!! The patient will dialize at night, and only require 1 (maybe more) exchanges in the day!!

Good luck!!

Traci

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Specializes in LTC/ rehab/ dialysis.

Ditto to what the other posters have said. Always mask, wash your hands, use your hand sanitizer immediately prior to your connect/disconnect. Anyone in the room with you and the patient needs to wear a mask as well. Any problems with slow fill or drain could be fibrin, you would need an order for Heparin from the Nephrologist for that. Watch your sterility, watch your patient for fluid overload/dehydration. As Shaggyjo said, your patient has been performing the PD at home and he/she along with the family members are a wonderful source of what "works" for them in terms of dextrose strength. And, of course, if you encounter a cloudy bag your patient more than likely has peritonitis, effluent will need to be cultured, nephrologist contacted, etc. Keep on eye on your patients exit site. An order should be obtained for exit site care. If it is pink or looks the least bit infected you would want an order for an antibiotic cream. An infected exit site can lead to a tunnel infection which can lead to peritonitis. Make sure your patients bowels are moving regularly. Constipation can lead to slow drains as well. Always keep the patients transfer set secured to their abdomen, so it doesn't get caught on something and pull on the exit site. Best of luck to you and your patient!!!!

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Very basic but important. Double check your connections and clamps.

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Specializes in LTC/ rehab/ dialysis.

PS ~ always make sure your lines are primed. Air in the lines will cause gas pain between the shoulder blades.

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