imperial

Would that mean that -130 would be good. A larger needle was used, not sure why, but that is what nurse told patient. Usually AP runs -200. This was contributed to larger needle and nurse said that -130 was good. Never been below -180. Actually, don't know if this is related but patient has the best day, after dialysis, then she has in a while. I

Can someone explain the arterial and venous pressures. Would a 130 - 150 be considered good?

Again I have come to believe that nurses who work dialysis, as well as techs are 'caught in the middle'. The corporations are out to make money for the stockholders. End of that. So, forget the part about the corporate person who calls it a village. He might be nice etc but remember he,also is accountable to someone and that is the stockholders. Make money!!! I watched today one patient who always sits in her chair until she stops bleeding, however, due to more patients, she wsa asked to sit in a w/c until the bleeding stopped to give her chair to another pt. This is the part of getting pts in and out.. and meeting schedule times. I am sure it is hard on the nurses. The RN apologized and thanked her for moving to the w/c.. I thought that was nice, she did not have to. I see more and more every day at the units there is alot of tension and trying to keep one's head above water. Often it is difficult to ask these questions and some of our patients, can't ask or do not have the ability to ask. We do allw e can to ensure they get care that is quality. thx.

Well, It certainly is interesting. We looked at the patient handbook which clearly states that a temp after dialysis, after the patient gets home, can be a reaction to the dialzyer.. The Rn stated NO... well, should we go with the RN or the handbook for patients that the unit gives with information? Then one neph said from the dialyzer .. ofcourse, the patient, to my recall is also taking zemplar although all labs are wnl... pth is only 190 or less... having some GI problems now. maybe just the stomach flu.. hopefully will go away,, oh yes, pt is also losing weight. Now, to our understanding if a pt is losing weight, without this being related to fluid being removed, it couldmean they need more dialysis time.. so we were told.. hmm. whoever said so many variables, so true.. but it is interesting to get such a wide variety of explanations.. and, actually, could be one of numerous things. thx.

Sorry, did not mean strange that tylenol took temp down, strange that it happens after dialysis and no one knows why.... then it goes away. wonder if it could be some inflammatory process? thx. just trying to understand what happens with various pts.. considering when these questions asked of staff or doc they seem not to know.. :)

thanks all... what is really strange is that the temp went away with tylenol, but apparently the patient has experienced this before wtih dialysis. Any ideas, staff at unit and doc say.. 'i don't know'...........hmm

thanks :)

Is anyone familiar with why a patient would develop a temp of 101 about3 hours post dialysis? Took two tylenol and in am no temp. Staff at this particular unit did not know why. This has happened before - temp post dialysis (3 hrs) then no temp after tylenol.. thanks.

The bottom line is the care is only as good as that individual who is giving it. There is good and bad in all dialysis corporations, all hospitals, etc. I can not say that one dialysis company is better than another for I have seen good and bad in all of the companies. Therefore, I say again... care is only as good as the staff who are providing it.......................and, kudos to those who care and provide good care in spite of the restrictions that corporations place on them. Again, today I observed how hard staff work in one unit. The more patients the more money (corporate level/share holders).

Thanks J.B. that would make sense. I believe this patient has a 180 size dialyzer, is that what you mean? How does the venous pressure actually cause change in amount removed. thanks. tried to look up in various books to find out but could not find. thx.

Welcome. This is a great group of well educated nurses who have helped me, and, continue to do so, understand dialysis. I work iwth patients on a advocate level.

Can someone explain what is meant by 'tight heparin'.. Thanks

j'nette: thanks.. think it explains. Now, if a patient becomes dizzy and has hypotension after dialysis it could mean too much fluid taken off. So, let me make sure I am understanding this.... if the patient only has rinseback taken off.. but loses, let's say, .7.. that means that there was additional fluid to be taken off. I guess the part that is confusing to me is how the machine tells that it is not too much. I am always interested in the rationale/mechanics, etc. thks.. today.. this particular patient entered and left .1 under and 500 was goal including rinseback.. so, guess only .1 needed to be taken off... One patient told me that she was told she might continue to urinate for the remainder of treatment. She is in similar situation with fluid goal, etc.. again, thanks.

J'nette: Yes, the clinical manager stated that he did not know why it was .7 less. Yes, the goal or number in the UFR was 500. I tried to find this in the manual (machine) as well as two books but can't.. Again, thx. Three of our clients got 'ultracare' t shirts.

Hello all: WOndering if you can answer this question. I have read all I can and can't seem to find the answer. (two books and research online) If the UFR is set for, as example, only 500 (including rinseback) and patient does not have fluid taken off, but after dialysis is .7 under pre weight, what is cause? Also, if UFR were 500 (400 rinseback) 100 fluid removal and patient left at .7 under what would cause be. Thanks. I