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Peritoneal Dialysis

Submitted by: Sanchez, Julienne Rowelie Santos, Trizh Tolentino, Danayarra Roman, RH Zhou, Princess Yoo, Min Woo (Section C)

Submitted to: Maam Flor Quintero
July 18, 2013

you'll drain the solution. . 2 Main types of Peritoneal Dialysis 1. you begin one exchange with a dwell time that lasts the entire day. You then repeat the cycle with a fresh bag of solution.  Its goal is to remove toxic substances and metabolic wastes and to reestablish normal fluid and electrolyte balance. into the bag. You don't need a machine for CAPD.Peritoneal Dialysis  Peritoneal dialysis is a treatment used for patients who are suffering from chronic kidney disease and no longer has properly functioning kidneys. typically three or four exchanges during the day and one evening exchange with a long overnight dwell time while you sleep. Continuous Cycler-Assisted Peritoneal Dialysis (CCPD) . you'll drain a fresh bag of dialysis solution into your abdomen. After 4 to 6 or more hours of dwell time. which now contains wastes. Your doctor will prescribe the number of exchanges you'll need. all you need is gravity to fill and empty your abdomen.CCPD uses an automated cycler to perform three to five exchanges during the night while you sleep. Continuous Ambulatory Peritoneal Dialysis (CAPD) -If you choose CAPD. In the morning. 2.It is treatment that uses your peritoneal membrane and dialysate as a filter to clear wastes and extra fluid from your body and to return electrolyte levels to normal.

Abdominal hernias 3. Severe neurologic disease. Severe diverticular disease of the colon 7. nephrostomy. Treatment of choice for patients with renal failure who are unable or unwilling to undergo hemodialysis or renal transplantation 5. PD continues to be the preferred dialysis modality for infants and young children 2. ileostomy. 2. or malignancy.Indications: 1. (caregivers can be trained to perform the peritoneal dialysis) 8. or ileal conduit 4. Severe psychological and social problems 6. movement disorder. Patients with diabetes or cardiovascular disease. and those who may be at risk for adverse effects of systemic heparin Contraindications: 1. Presence of colostomy. fibrosis. Severe chronic obstructive pulmonary disease 9. many older patients. or severe arthritis preventing self care. The one absolute contraindication to chronic PD is an unsuitable peritoneum due to the presence of extensive adhesions. Patients with difficult vascular access 4. Recurrent chronic backache with preexisting disc disease 5. Patients with severe hemodynamic instability on hemodialysis 3. Malnutrition .

 Solutions that are too cold cause pain and vasoconstriction and reduce clearance. Microwave heating of the fluid is not recommended because of the danger of burning the peritoneum. the dialysate is warmed to body temperature to prevent patient discomfort and abdominal pain and to dilate the vessels of the peritoneum to increase urea clearance. and serum electrolyte levels are recorded.  The patient is encouraged to empty the bladder and bowel to reduce the risk of puncturing internal organs. Dry heating is recommended (heating cabinet. Solutions that are too hot burn the peritoneum.  Baseline vital signs.Procedure: PREPARING THE PATIENT  Explain the procedure to the patient and obtain signed consent for it.  Assess the patient’s anxiety about the procedure and provides support and instruction Additional Preparation:  In addition to assembling the equipment for peritoneal dialysis.  Antibiotics may be added to treat peritonitis. weight. incubator.  Heparin may be added to prevent blood clotting and resultant occlusion of the peritoneal catheter. or heating pad). nurse consults with the physician to determine the concentration of dialysate to be used and the medications to be added to it.  Before medications are added. .