A fistula in hemodialysis is typically created surgically in the forearm, where an artery is connected to a nearby vein. This creates a durable access point for hemodialysis treatments.
Creatinine: Elevated because it is a waste product that the kidneys normally filter out.
*BUN (Blood Urea Nitrogen): Elevated due to decreased kidney function, as the kidneys normally excrete urea.
*Phosphorus: Elevated because the kidneys cannot efficiently remove phosphorus from the blood.
The fluid compartments of the body include the intracellular space (inside of body cells) and the extracellular space (outside of body cells). The extracellular space is divided into the interstitial space (in between body cells) and the intravascular space (inside of blood vessels). Only about 10% of body water is contained in the intravascular space with 20% in the interstitial space. The majority of body water (70%) is contained in the intracellular space.
One-half teaspoon of salt (sodium chloride) is equal to about 1,150 mg of sodium. Patients on hemodialysis must limit sodium intake, so they should avoid using table salt or salt substitutes (which are high in potassium) as well as eating high-sodium foods, such as prepared foods, lunch meats, bacon, and ham. Patients must be educated about reading labels. If patients ingest too much sodium, they may have increased fluid retention and swelling, increased weight, and increased blood pressure.
When using an alcohol-based hand rub, the hand rub should be applied to one palm and the hands rubbed together until the hand rub is dry, being sure to thoroughly cover the entire hand surface, including between the fingers. It's important to use the volume of hand rub recommended by the manufacturer. Hands should be washed with soap and water if any dirt or debris is evident or if the hands are contaminated with body fluids.
The mass transfer coefficient of a dialyzer refers to how well solutes (usually urea) pass through the dialyzer membrane. The mass transfer coefficient is based on the membrane clearance (Ko) times the surface area (A) of the dialyzer. Membranes with a higher KoA are more permeable than membranes with a lower KoA. Most dialyzer membranes have KoA values ranging from 800 to 1600 mL/min. A membrane with low efficiency has a KoA of less than 450 mL/min, and with high efficiency, it can be more than 700 mL/min.
If a dialysis machine is set up to use 36.1X parts dialysate, and the concentrate proportioning ratio calls for 1.00 part acid and 1.10 parts bicarbonate, 34 parts of water are needed:
1.00 + 1.10 + 34 = 36.1. Concentrates are labeled with symbols (such as triangles, ovals, and rectangles) to
indicate which concentrates are compatible in order to prevent errors in mixing. Each concentrate must be diluted with a precise volume of water.
These foods are high in potassium. In hemodialysis patients, controlling potassium intake is crucial because impaired kidney function can lead to potassium buildup in the blood, which can be dangerous. Therefore, patients are often advised to limit consumption of foods high in potassium to prevent complications.
In patients undergoing hemodialysis, bone disease, often referred to as renal osteodystrophy, is a common complication due to disturbances in mineral metabolism. To assess bone disease accurately, healthcare providers monitor calcium and phosphorus levels, along with parathyroid hormone (PTH) levels. These lab values help in understanding bone mineral metabolism and identifying any abnormalities that may require intervention.
Vascular access: This term encompasses the various methods used to access the patient's blood, such as arteriovenous fistulas, arteriovenous grafts, or central venous catheters. It is crucial for effective hemodialysis treatment because it allows continuous blood flow to and from the dialysis machine.
Blood leak detectors in hemodialysis machines are designed to detect any leakage of blood outside of the dialyzer or blood tubing immediately, ensuring patient safety by preventing potential blood loss incidents.