Author Topic: Questions Part 44 (part b)  (Read 1379 times)

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Questions Part 44 (part b)
« on: August 30, 2009, 09:58:25 AM »
Robbie



Joined: 12 Mar 2003
Posts: 1

   
PostPosted: 12 Mar 2003 19:21    Post subject: Which needle should be stuck first    
the art or ven and why?

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: 12 Mar 2003 19:57    Post subject: Robbie    

There is not a set rule as to which needle should be put in first. <
><
> I prefer to stick the arterial needle in first and my reasoning is this. If I infiltrate the arterial needle, then I need to stick further up the access. If I stick the venous needle in first, infiltrate, then where am I going to go? I always want to bypass the infiltrated area so that the hematoma doesn't grow and cause more damage to the access.

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Lynn



Joined: 01 Mar 2003
Posts: 6

   
PostPosted: 14 Mar 2003 04:39    Post subject: Sodium Modeling and Uf Profiling    

Would like to share that I tried both Sodium Modeling (145 linear) and UF profiling (2/3 which I think is program #1 on a FR 2008H). The outcome was, they made certain portions of the tx gentler, but it was like a trade off, because then other portions of the tx were more strenuous. <
><
>One negative thing was that both programs gave me some insomnia that night. Not real bad insomina, but did affect my sleep. With the Sodium Modeling, my high conductivity alarm came on several times, so the machine's cali
ation affecting the cond. may of been the problem more so than the modeling and I have no way to tell unless I try it on another machine. <
><
>I don't fully know what it means, but I have come to notice that if I have a tx with no conductivity alarms, I will sleep great that night. If there are any cond. alarms, or if a program is not right for me, I will get insomnia that night. <
><
>I was so glad I tried these two programs (with your encouragement) so I could see for myself if they were beneficial to me. My tech put up a fuss, because she said UF profiling is only for fluid overloaded patients. But I had gotten a doctor's order and the nurse told her to run me accordingly. <
><
>Another thing I noticed with the Fluid Profiling program used was, I felt more tense in the beginning portion of the program when the UF was higher, and at the end when the UF was lower, the moderate Restless Leg sensations I regularly have the last hour of the tx, were completely gone. <
><
>So, like I said, it was like a tradeoff. If it wasn't for the insomnia I experienced with both programs, I would want to try them again. I would also like to try them under different conditions (i.e. higher fluid gain after a weekend, menses etc).

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: 14 Mar 2003 15:52    Post subject: Lynn    

Have you tried just sodium modeling without the UF profile? If not you might want to try that. Also you may want to in the future try the other UF profiles. You never know what may help you until you try them out. Glad that you were
ave enough to try them. <
>Good Luck!

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Lynn



Joined: 01 Mar 2003
Posts: 6

   
PostPosted: 14 Mar 2003 19:03    Post subject: programs    Reply with quote Edit/Delete this post Delete this post View IP address of poster
The first tx I tried the Sodium Modeling. The 2nd tx, I tried the Sodium Modeling again, but that was when the cond alarm kept going off. The third tx, I went back to straight 140 sodium plus I tried the UF Profiling. I did not get to try both sodium Modeling and UF Profiling together on a tx. That's what I had wanted to do, but when the cond. started acting up, I didn't get to try both together. The cond alrm did not go off when I tried UF Profiling alone on the 3rd tx. Rather than risk more insomnia, I am going to give it a rest while I try to think how to proceed. Mabe after a few good night's rest I'll know Thanks again for your support. That's all I needed to try these programs. I didn't feel safe until I could be assured the txs wouldn't be rough. That was the question mark that had been in my mind.

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patient



Joined: 30 Oct 2002
Posts: 137

   
PostPosted: 20 Mar 2003 04:57    Post subject: Conductivity    Reply with quote Edit/Delete this post Delete this post View IP address of poster
My regular machine has a conductivity of about 14.3-14.4 while I run a straight 140 sodium. I have no problems on this machine. Everytime the machine gets switched out for maintenance and I am put on a machine with a cond in the 13's, I always have a problem. This happened today. I got an hour from the end of tx and began to feel weird. My head was very unclear and I got warm. I had the nurse give me 100cc's of saline and I was ok enough to make it to the end of tx. What is it about lower cond. that affects me? <
><
>I was reading where another patient who is on sodium modeling I think, had her cond go up to 15.0 and she said it was the best tx she ever had. What is the connection to higher cond and feeling better?

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: 20 Mar 2003 15:08    Post subject: Patient    

My best advice is to learn how your machine is programmed. The base sodium should be set at 140 otherwise it could go lower and possibly cause the problems you experienced. It sounds like the fluid was pulled from your body faster than it usually is and what you felt was your bodies response.<
><
>Sodium modeling helps support the BP as fluid is pulled from the body. Without it, fluid can be pulled faster and cramping and/or a low BP can occur much sooner in the treatment.<
><
>Where the sodium modeling starts is a unit/ company policy. Most places I worked were fine with a 145 linear. That means that the sodium started at the beginning of the treatment was 145 and during treatment, gradually lowered to 140. You may have to experiment to see what works for you. I would recommend that you try a 145 linear program any time you are on a machine other than the one you are comfortable with. Just remember to make sure the program is turned off 30 min before your treatment ends.

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patti



Joined: 20 Mar 2003
Posts: 2

   
PostPosted: 20 Mar 2003 18:31    Post subject: bad stick    

There have been a couple of times that a needle stick hurt. It didn't infiltrate, but felt painful and sore. I have a fistula and my access is right at the top. Would you say a hurtful stick like this is due to sticking too deep and/or too fast? It seems like both are happening when I feel pain with the stick.

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: 20 Mar 2003 20:06    Post subject: Patti    

It could be the way your fistula is stuck, but it could also be that you have a nerve close by that is also being irritated. Is there one person who doesn't hurt you? If you, can you ask for that person to stick you each time until your fistula toughens up?<
><
>What you can do to help during the run is have more lidocaine injected into the puncture sites to help deaden the area. This sometimes helps if it is especially irritating.

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Norman



Joined: 21 Mar 2003
Posts: 1

   
PostPosted: 21 Mar 2003 14:52    Post subject: high pulse    

How common is it for patients to have a high pulse at the end of tx? Mine is in the 90's during tx, but usually jumps to 100's by the last bp and when I do my standing it goes sky high to 110 -140. I have had my heart thorougly tested and it is fine.

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: 23 Mar 2003 15:54    Post subject: Norman    

It happens, but it is not all that common for a heart rate to go up above 110. If it does, then the most common cause is that you are getting yourself too dry. You may need to increase your DW by at least .5 kilos and see how it goes from there. If your heart rate stays up for an extended period of time, then you may need to be recanulated and given some saline to help
ing that heart rate down.

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Caregiver



Joined: 28 Mar 2003
Posts: 1

   
PostPosted: 28 Mar 2003 12:39    Post subject: Systemic disease    

 />What is systemic disease?

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: 28 Mar 2003 15:02    Post subject: Caregiver    

A systemic disease affects the entire body, not just one organ or just one localized area.<
> Examples: Lupus, Hypertension, Arthritis, Blood infections, Cancer and so on.
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