NCLEX RN Practice Question 446

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Nclex Practice Questions:

PERITONEAL DIALYSIS

Description

  • The peritoneum acts as the dialyzing membrane (semipermeable membrane) to achieve dialysis during kidney failure.
  • Peritoneal dialysis (PD) works on the principles of osmosis, diffusion and ultrafiltration; PD occurs via the transfer of fluid and solute from the bloodstream through the peritoneum into the dialysate solution.
  • The peritoneal membrane is large and porous, allowing solutes and fluid to move via osmosis from an area of higher concentration in the body to an area of lower concentration in the dialyzing fluid.
  • The peritoneal cavity is rich in capillaries; therefore it provides a ready access to the blood supply.

Contraindications to peritoneal dialysis

  • Peritonitis
  • Recent abdominal surgery
  • Abdominal adhesions
  • Other gastrointestinal problems such as diverticulosis

Access for peritoneal dialysis

  • A siliconized rubber catheter such as a Tenckhoff catheter is surgically inserted into the client’s peritoneal cavity to allow infusion of dialysis fluid.
  • The preferred insertion site is 3 to 5 cm below the umbilicus; this area is relatively avascular and has less fascial resistance.
  • The catheter is tunneled under the skin, through the fat and muscle tissue to the peritoneum; it is stabilized with inflatable Dacron cuffs in the muscle and under the skin.
  • Over a period of 1 to 2 weeks following insertion, fibroblasts and blood vessels grow around the cuffs, fixing the catheter in place and providing an extra barrier against dialysate leakage and bacterial invasion.
  • If the client is scheduled for transplant surgery, the peritoneal dialysis catheter may either be

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