Nursing Management and Risks of Peritoneal Dialysis

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Peritoneal dialysis is mainly concerned with the stomach and peritoneal cavity. The process is simply getting fluid out of the body when the kidneys have malfunctioned.

The kidneys’ primary role is to filter the blood and eliminate all the junk from the body into the potty through the urinary tract. If the kidneys fail to perform properly due to certain health issues, getting excess fluid and toxic wastes out of the body will be compromised; thus, peritoneal dialysis is recommended.

How does Peritoneal Dialysis Work?

In the belly, a tube is inserted to indwell within the peritoneal cavity. The primary purpose of this procedure is to fill the body up with a solution. The solution, on the other hand, is supposed to attract fluid and fill the body with sugary-type substances using a plastic encasement.

After filling the body with the prescribed solution, the tube has to stay inside the peritoneal cavity for a while to make sure that the body has been filtered from waste products. The solution for this procedure has high solutes that promote osmosis. All excess fluids inside the body are expected to become attracted to the solution that will then be extracted and drained from the body.

The Three Important Aspects

There are three important aspects concerning peritoneal dialysis – in, sit, and drain.

  1. In – when fluid is put inside the peritoneal cavity
  2. Sit – when the fluid is made to sit inside the cavity for a recommended period to attract excess fluid
  3. Drain – getting the excess fluid out of the body

A Home-based Procedure

Peritoneal dialysis can actually be done at home. Clients who opt to do the procedure at the comforts of their home are also hooked up to the machine and are provided with about a liter or two of fluid that should be introduced in the peritoneal cavity. The fluid will sit for about an hour and a half, and after that time, the fluid can now be drained out.

By using high concentration of solutes like high sugar or low potassium, they are bound to attract all the unnecessary waste products produced in the body that was supposed to be filtered out by the kidneys that have malfunctioned.

Weighing the Client

Before and after going into peritoneal dialysis, the client must be weighed to acquire information on the volume of fluid that was lost after the procedure. Weighing the client is important in assessing if the dialysis is effective or if the client has gained or lost any weight.

The Benefit

One of the main benefits of having peritoneal dialysis, aside from relieving the client of toxins, is the absence of shunts on the arm, or catheters sticking out of the chest. There are no malformations involved because there’s only a small tube that’s sticking out of the stomach which can be hidden if not being used.

The Risk

There is a high risk for infection when dealing with peritoneal dialysis since it’s a procedure that can be done at home for at least three to four times a day, on a daily basis or depending on the doctor’s order. People who opt for doing the procedure at home instead of doing it in clinics have a high risk of being exposed to infection due to the unsanitary environment.

Education is important in preventing infection from happening. Also, instruct them to watch out for signs of infection which is usually very cloudy and smelly output or drainage.

Test Question

Regarding the client’s output, do you expect the drainage to have the same amount of fluid introduced or to have more than what was given? For example, if you put in one unit, how much fluid is expected to get eliminated from the body?

Answer: At least more than one unit or reaching two units. Remember that the main goal of peritoneal dialysis is to allow people to release waste products in the form of pee which is why having doubled output is a good sign.

By remembering these critical factors, you are saving your dialysis clients from infection and potential complications.

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