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watch their blood glucose levels because it is absorbed so they can get hypoglycemic with the runs of dialysis. Just remember fill, dwell, and drain, a typical dwell time after the dialysate is infused is going to be 4-6 hours. The fill time again can be in 10-15 minutes; the abdomen distends with that volume. The drain time is going to be just as quick as the fill time is. It is going to be a little bit longer because you should drain more than that volume is that is actually is required to fill the abdomen. Complications of course is going to be peritonitis, pain and this is typically usually upon initiation of therapy, within the first two weeks. Exit site and tunnel wound infections, clients are going to be high riskfor dialysate leaks which of course will cause peritonitis, infection of the peritoneum. Other complications can be bowel or bladder perforation; this is going to be from volume or catheter dislodgement of the peritoneal dialysis catheter.Our nursing care for peritoneal dialysis is not even specific to peritoneal but to hemo- and peritoneal dialysis are going to be evaluate their baseline vital signs, what their weight is before and after dialysis, electrolyte values before and after are going to be important to consider also. Also with peritoneal dialysis, observe the outflow amount and the pattern of the fluid, observe, definitely need to measure what went in vs. what came out, and the color definitely. The color of your dialysate solution after it drains should be a serous color; little yellow. It shouldn’t be bright yellow, orange or brown. Those are definite indicators that there’s a problem whether it be infection or perforation of something also, if an internal organ and you’re seeing color changes to their dialysate. Renal transplant, we’ll talk about very briefly because we can get very detailed about transplants. Candidate selection is going to be for the assessment for comorbidities, that is really going to tell if they
8are a candidate or not, what other comorbidities they have that are going to prohibit their quality of life even if they were to have a transplant. Sources can be from a non-heart beating donor or cadaver, or a living relative. They are ruled out for cancer, hypertension, or systemic infections. Operative procedure, transplant is so there is palpation possible; the kidney is not transplanted into where it normally is, it’s transplanted so it can palpate where it is at. Imagine that, it is important for a HCP to be able to assess for that.Postoperative care for transplant clients of course are going to be the most crucial timeframe is going to be that first 48 hours afterwards, where you are really monitoring for oliguria or diuresis. A lot of these clients have to actually be dialyzed in the interim, to give that new kidney a chance to take over to work.