PERITONEAL DIALYSIS

PERITONEAL DIALYSIS

Purpose

To meet the ends of the acute renal failure patient, peritoneal dialysis exchange is completed as ordered per physician and according to the following guidelines.

POLICY

Acute peritoneal dialysis consists of exchanges done every one to two hours for more that 4 hours.

Nursing procedure

  1. Mask self and patient/family.
  2. Wash hands and don’t sterile gloves.
  3. Remove bags of dialysate from outer wrap and inspect for clarity, hang on IV pole.
  4. Bags may be warmed using a heating pad.
  5. Remove dialysis tubing manifolds and buretrols from box, close all roller clamps. Using aseptic technique connect buretrols to tubings, then manifold to buretrol.
  6. Remove drain bag from box, spike drain bag and hang on side of bed.
  7. Spike bags of dialysate.
  8. Purse air out of tubing from dialysate bags to drain bag by opening the clamps between fill bags and drain bag. Close clamps when done.
  9. Remove IPD adapter or extension set from outer warp and place on patient end if dialysis tubing.
  10. Luer lock the IPD adapter onto the patient’s tenchhoff catheter.
  11. If patient has not been on PD, purge air from patient end of tubing by opening clamps between patient and drain (keep fill clamps closed).
  12. If patient has been on PD, allow the patient to drain before proceeding.
  13. Allow patient to fill with prescribed amount of dialysate.
  14. Empty drain bag and measure amount.
  15. Flush drainage down hopper or toilet.

 

NURSING IMPLICATION:

  1. Effluent dialysate should be examined for color, clarity and amount.
  2. Sterile samples of dialysate effluent should be obtained from the drain bag by draining from the drain bag into a sterile container and taking the sample from the sterile drainage after measuring the amount.
  3. Exit site care should be done every day (see procedure for Tenchkhoff Catheter Exit site and Dressing Change).
  4. Dialysis tubing should be changed with each PD set up, not to exceed 72 hours. Dialysis tubing changes are documented on the Acute Peritoneal Dialysis Record.

DOCUMENTATION:

Documentation is done on the Acute Peritoneal Dialysis Record. Each exchange should be noted and the following information recorded:

  1. Exchange number
  2. Dialysate concentration
  3. Volume of exchange
  4. Medications added
  5. Amount of effluent obtained, if drained
  6. Appearance of effluent
  7. Tubing change

Document patient education in Notes or Teaching Record, as applicable to area.

 

 

EQUIPMENT

  • PD Solution – Baxter dineal
  • 2 Blue Outlet Port Clamp
  • 2 Manual dialysis Tubing (Acute)
  • 1 Drain Bag (dialysis acute)
  • 1 Intermittent Peritoneal Dialysis (IPD) Adapter Set

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