Essay on Dialysis Experience

2920 Words Mar 22nd, 2012 12 Pages
Dialysis Experience 3/23/2012 Medical Surgical

Hemodialysis (HD) is one of several renal replacement therapies used for the treatment of end stage kidney disease (ESKD) and kidney failure. Dialysis removes excess fluids and waste products and restores chemical and electrolyte balance. HD involves passing the patient’s blood through an artificial semipermeable membrane to perform the filtering and excretion functions of the kidney. One important step before starting regular hemodialysis sessions is preparing the vascular access; ideally, a vascular access should be placed weeks or months before you start dialysis. The
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| Rationale for Rx for this clientAnemia associated with chronic renal failure | Dose/freq ordered:24h dose max: | Nursing physical assessment:• Monitor blood pressure before and during therapy. Inform health care professional if severe hypertension is present or if blood pressure begins to increase. Additional antihypertensive therapy may be required during initiation of therapy• Monitor for symptoms of anemia (fatigue, dyspnea, pallor)• Monitor dialysis shunts (thrill and bruit) and status of artificial kidney during hemodialysis. Heparin dose may need to be increased to prevent clotting. Monitor patients with underlying vascular disease for impaired circulation | | Scheduled admin time:1.2. | | Mechanism of action:Stimulates erythropoiesis (production of red blood cells)Therapeutic Effect(s): Maintains and may elevate RBCs, decreasing the need for transfusions | Actual admin. time (explain variance): | Nursing lab assessment:• May cause ↑ in WBCs and platelets. May ↓ bleeding times» Monitor serum ferritin, transferrin, and iron levels to assess need for concurrent iron therapy. Transferrin saturation should

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