I am an MDS Coordinator in South Carolina. My co-worker careplanned dialysis on one of our residents and she included checking the bruit and the trill in the plan of care. We had our annual survey a couple weeks ago and were asked for our dialysis policy. We don't have a dialysis policy. Now our staff development nurse is trying to write a policy and/or procedure on shunt care and having a difficult time of it. Was wondering if anyone has something they can share or some ideas on what to include other than removing pressure dressing, checking bruit and trill, and not taking BP on the shunted arm? I don't recall ever having a policy on shunt care it was just a standard of care provided for a resident on dialysis. Thanks in advance for your suggestions.
Oct 9, '06
You should also protect the arm (if it is in the arm). No tight sleeves, no watch, bracelet, nothing to hinder circulaiton. Pt should not sleep on that arm. Assess for bruising /infiltration. If infiltration had occured from tx, extremity should be elevated and cold applied that day and evening, alternate heat and cold the following day and continue to keep elevated to reduce swelling/bruising.
Signs of infection could be pain, swelling, draining, warmer than other extremity.