To outline the procedure for providing closed system peritoneal dialysis for infants and children requiring small volumes ( < 150 ml) of dialysate.
Nursing staff from the dialysis unit will be responsible for set-up of the closed system as well as maintenance of the system using aseptic technique. Sterility of the system should be maintained throughout the entire time peritoneal dialysis is in use. For this reason, only the dialysis nurse may “open” the system (bag changes, obtaining specimens, etc.)
1. Check physician orders for fill volumes, fill Drain and dwell time.
2. Assure the daily-nate coil is completely Enclosed in K-pad with warming device “on”
|Dialyate should be kept warm at all times.|
|3. Obtain VS prior to initiation of therapy.|
|4. Fill buretol with prescribed fluid to 10 ml above Desired patient fill volume.||10 ml over-fill assures accurate delivery of Dialysate volume and prevents air from entering
|5. Turn stopcock off to drain and open roller clamp between buterol and coil.||To prevent patient overfill, do not leave system Unattended when filling buterol or patient.|
6. Close roller clamp when prescribed fill volume has been delivered.
7. Close roller clamp when prescribed fill volume has been delivered.
|8. Turn stopcock off to fluid/buterol after prescribed dwell time, and open to collection bag.||Collection bag should be hanging at level below patient to facilitate gravity drainage
of peritoneal cavity.
|9. Allow full drain time.||
Drainage time will vary with each patient, and each cycle.
10. Measure output and calculate +/- balance
Documentation Dialysis flow sheet:
- Time cycle
- Concentration of dialysate
- Fill volume
- Drain volume
- +/- difference per exchange
- Cumulative fluid balance
- k-pad in use and “on”
Document hourly and cumulative output totals on unit specific flowsheet.
- Dialy-nate ® set
- Prescribed dialysate solution