Hemodialysis

1. Definition of "hemodialysis."

1. It is a process that mimics the functions of the kidney.

2. In hemodialysis, blood is removed from the radial or brachial artery and put into a dialyzer to filter blood.

3. Hemodialysis has several functions.

1. Removal of toxic substances and metabolic waste.

2. Regulation of fluid balance through removal of excessive body fluid.

3. Maintenance of serum electrolyte balances.

4. Correction of acid-base imbalance.

2. Types of vascular access for hemodialysis.

1. Arteriovenous external shunt (an external silastic tubing placed in an adjacent artery and vein).

2. Arteriovenous fistula (created surgically by connecting an artery to a vein).

3. Graft (an additional segment added to client's own vessel).

3. Possible symptoms client may feel during or after dialysis.

1. Follow diet as prescribed (restrict protein, sodium, and potassium).

2. Restrict fluid as prescribed.

3. Assess for fluid buildup.

1. Measure intake and output.

2. Weigh daily.

3. Monitor blood pressure.

4. Avoid infection.

5. Get adequate rest and exercise.

6. Monitor for symptoms of hyperkalemia (muscle weakness and flaccidity, irregular pulse).

4. How to adequately care for access blood route.

1. Never allow anyone to take blood pressure, draw blood, or give injections on the arm being used for dialysis.

2. Avoid trauma to site.

3. Avoid constrictive clothing on affected arm.

4. Avoid heavy lifting.

5. Cleanse cannula as instructed and apply a dry, sterile dressing.

6. Assess for and report any signs of infection, bleeding, or lack of circulation.

7. Palpate the site for a vibration (thrill), which indicates blood circulation, or listen with stethoscope for a rushing sound (bruit). Report absence of either immediately to physician.

5. Possible complications.

1. Infection.

2. High or low blood pressure.

3. Heart arrhythmias.

4. Hemorrhage.

5. Air embolus.

6. Muscle cramps.

7. Hepatitis.

8. Disequilibrium syndrome (symptoms include nausea, vomiting, confusion, headaches, restlessness, seizures).

9. Anemia.

10. Hypovolemia and shock.