WHAT TO EXPECT WITH YOUR INPATIENT DIALYSIS PATIENTS
ESRD: End Stage Renal Disease or Chronic Kidney Disease Stage 5
*ESRD patients need dialysis to Live*
GFR: Glomerular Filtration Rate -- Key lab value used by provider to determine diagnosis of ESRD
Confession Time: I was an inpatient nurse for 8 years, and the only thing i really new about dialysis patients is that I had a 50% chance they would be gone for half the day.
I didn't know really what dialysis did. We can all agree dialysis nursing did not get much time in nursing school.
Agenda Items:
1) K (Potassium Removal) - Dialysis patient retain Potassium. Potassium is lethal if too high, Dialysis is amazing at lowering potassium.
2) Urine Output/Production -Ask the patient what is normal for them
3) Ph (Phosphorus Removal) - Low Phosphorus diet and binders are key here for patients with high phosphorus levels
Phosphorus Binders: Calcium Acetate (Phoslo), Sevelamer (Renvela, Renagel), Calcium Carbonate (Tums). MUST BE GIVEN WITH FIRST BITES OF FOOD. If not eating or NPO - OK to hold Binders. Not sure, ask your patient (document: not given per patient, patient not eating)
4) Epo Production - Hormone that stimulates production of red blood cells. The kidney's make this!! ...until they don't.
Urine Output: If it is normal for them not to make urine, document that in a comment when you document their output for your shift. (per pt, does not make urine, dialysis patient, anuric, etc.).
But...some Dialysis patients still make urine. Especially Peritoneal Dialysis Patients :)
Blood Transfusions and dialysis - Sometime they cannot be avoided. If they are having symptoms of low blood pressure, fatigue, vertigo. ESRD patients working with a transplant team have blood work sent to the transplant team every month. One of the questions when collecting the labs is: Did you receive a blood transfusion?
Other need to know 2 things about Dialysis Patients in the inpatient setting:
1) Anything you need to know about dialysis patients, the dialysis patient will tell you. (do you make urine, what day is your dialysis, is this a normal weight for you? Are you short of breath? )
2) All dialysis patients need dialysis to stay alive, but they all present differently. Enjoy the visuals!
00:00 Kidney's on Strike
01:19 Dialysis Confessions
02:09 Agenda Items
02:35 Dialysis Patient #1
04:35 Dialysis Patient #2
05:55 Dialysis Patient #3
06:05 Dialysis Patient #4
08:20 Nursing Orders to Expect
08:55 AKI - Not the same as ESRD
09:20 Bubba
DISCLAIMER: This video is intended for education purposes only and is not intended as medical advice
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2 авг 2024
