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Key concepts and information related to the final exam for hemodialysis. It provides an overview of the three endocrine functions of the kidney, the functional unit of the kidney, the acceptable ranges for dialysate ph, conductivity, and temperature, as well as the components of dialysate. The document also compares peritoneal dialysis and hemodialysis, explains the concept of countercurrent flow, and discusses the role of bicarbonate in dialysate. Additionally, it covers topics such as hyperkalemia, diffusion, ultrafiltration, recirculation, infiltration, hemolysis, endotoxin, reverse osmosis, air embolism, and the treatment of hypotension and cramping in hemodialysis patients. The document also includes information on vascular access assessment, water system testing, and fluid removal calculations. This comprehensive coverage of hemodialysis-related topics makes this document a valuable resource for students preparing for a final exam in this field.
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Erythropoietin : A hormone that regulates red blood cell production. Renin : A hormone that affects sodium and potassium balance, as well as blood pressure. Calcitriol : The active form of vitamin D3 needed to absorb calcium from food.
The functional unit of the kidney is the Nephron. Approximately 1% of the water filtered by the kidney is excreted in 24 hours.
The acceptable pH range for dialysate is 6-. The acceptable conductivity range for dialysate is 13.0-15.. The acceptable temperature range for dialysate is 35-39°C.
The three components of dialysate are: 1. Reverse Osmosis Water 2. Acid Concentrate 3. Bicarbonate solution
The electrolytes found in dialysate include: - Sodium - Calcium - Magnesium
The top two leading causes of Renal Failure are: 1. Diabetes Mellitus 2. Hypertension
Other causes include glomerulonephritis and polycystic disorders.
Peritoneal Dialysis (PD) : 1. Daily procedure 2. Performed at home 3. Occurs in the peritoneal membrane 4. Less dietary and fluid restrictions
Hemodialysis : 1. Performed 3 times per week 2. Usually done at a dialysis center 3. Occurs in an extracorporeal dialyzer 4. Stringent dietary and fluid restrictions
The pressure is negative in the dialysate compartment of the dialyzer. Countercurrent flow is the exchange mechanism where blood and dialysate flow in opposite directions, allowing for diffusion and osmosis to occur simultaneously.
Bicarbonate in the dialysate: - Provides electrolytes for the dialysate - Acts as pH buffers to neutralize metabolic acidosis, substituting the kidney's pH balancing function
The renal dietician develops a meal plan based on the patient's nutritional needs and dietary preferences.
Patients can lower their phosphorus levels by: 1. Reducing phosphorus consumption 2. Taking phosphate binders
High Potassium Foods : - Bananas, Potatoes, Tomatoes, Oranges, Spinach, Melons, Avocado
High Phosphorus Foods : - Milk, Cheese, Nuts, Chocolate, Cola drinks
Hyperkalemia : Elevated potassium levels Diffusion : The movement of solute from an area of greater concentration to an area of lesser concentration Ultrafiltration : The movement of solvent (water) from an area of higher hydrostatic pressure to an area of lower hydrostatic pressure Recirculation : When dialyzed blood returning through the venous needle re-enters the extracorporeal circuit through the arterial needle Infiltration : Accumulation of excess substance in tissue or cell, resulting in a hematoma Hemolysis : Rupture or destruction of red blood cells Endotoxin : Toxic particles left behind by dead bacteria Reverse Osmosis : A form of water filtration where hydraulic pressure causes water to move from regions of low water concentration (high