Author Topic: Questions Part 45 (part b)  (Read 2122 times)

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Questions Part 45 (part b)
« on: August 30, 2009, 03:36:40 PM »
Isabel



Joined: 11 May 2003
Posts: 25

   
PostPosted: Wed May 21, 2003 10:30 am    Post subject: Peritoneal Dialysis...Diabetics    

Can diabetics be a candidate for Peritoneal Dialysis? I ask this question because I read in ESRD the sugar in the dialysate may cause you to gain weight. <
>Does Medicare/Medicaid covers this treatment?<
><
>

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Isabel



Joined: 11 May 2003
Posts: 25

   
PostPosted: Wed May 21, 2003 11:16 am    Post subject: Do you have an idea????    

What can be the reason....., I learned about the reuse machines, I learned about the water. I did not know there were 3 different choices for ESRD. My mother is diabetic, can she a good candidate of PD? I did not find any answer in the site. Pls advise! Thanks again!

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: Wed May 21, 2003 12:48 pm    Post subject: Isabel    

You will have to ask your mother's nephrologist if she is a canidate for Peritoneal dialysis. My experience has been that the more
ittle diabetics, and those who do not take care of themselves, are not. But some diabetics who are very dedicated to monitoring their blood sugars and do not need lots of insulin, esp. extra insulin and watch their diet very carefully, these can do well on PD. But only your Nephrologist can tell you this.<
><
>The choices for dialysis are:<
>In-center hemodialysis, this is the most common.<
>Slow nocturnal dialysis. This is done at home while the patient sleeps. It is a form of home hemo.<
>Home hemo: This is the same as in-center hemo, only done at home with a helper.<
>CAPD: Continuous Ambulatory Peritoneal Dialysis. It is a form of PD.<
>Peritoneal dialysis on a PD machine (cycler): This is a form of PD done at night while the patient sleeps, usually done at home but has been done in center where offered.<
>Not all units/ companies offer all the different forms of dialysis, though they should. You will have to first talk to your nephrologist to see what is offered and what your mother is the best canidate for.<
><
>Medicare does pay for dialysis and even home dialysis. You will have to check with your social worker and the home dialysis unit in your area for the particulars. Good Luck! <
>

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RedheadedReptile



Joined: 09 Mar 2003
Posts: 69

   
PostPosted: Thu May 22, 2003 6:04 pm    Post subject: K Bath mix up    

Author Comment <
>RedheadedReptile<
>Registered User<
>Posts: 21<
>(5/22/03 8:04:21 pm)<
> K bath mixup-- possible side-effects?<
>--------------------------------------------------------------------------------<
> On Saturday, I was put on a K3 bath instead of the K2 I'm supposed to have... it was discovered after 3 hours of a 4-hour treatment. The charge nurse was instructed by the doctor on call to put me on a K0 for the remainder of the treatment. Blood was tested on Tuesday to verify that my potassium level had returned to normal.<
><
>What, if anything, might have happened had the mistake not been caught? Or would I have had to have been on a K3 for more than one treatment for any effect to be noticed? <
>

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: Thu May 22, 2003 6:13 pm    Post subject: Red..........    

The fact that the mistake was caught and you were put on a k+ 0 Bath, you would not have any problems.<
><
>If it had not been caught, your K+ would have been a bit higher than normal and if you ate more high K+ foods than normal, your heart might have been affected, rapid heart rate, feeling not right. But I don't think you would have been in any danger, unless you sat down and ate several bananas, oranges, and other citrus. <
><
>This is where it is a good idea to go over with your tech who puts you on a check list, making sure that the dialysis perscription is dialed in right, that includes the right bath. It only takes 1-2 min and can save your life!

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: Fri Jun 20, 2003 5:14 am    Post subject: End of Life Issues    

Comment <
>bklv
ewerworldnetattnet<
>Unregistered User<
>(6/19/03 8:33 pm)<
>Reply Dialysis and Dying<
>--------------------------------------------------------------------------------<
> My father is 74 and has been on dialysis for @ 6 years. Unfortunately, he is in Canada and I'm living in the US.<
>My father has went into the hospital the middle of November 2002 and is still there. I went back for a quick visit this past Christmas (knowing that this would probably be the last time I would see him . I am in constant contact with my Mother on his status (as well as hers). Being at a distance I find it tremendously difficult to found out what EXACTLY is happening with him. This experience has been quite a roller coaster ride for my whole family not to mention my poor father. I was wondering if anyone could tell me the steps that a dialysis person goes through before they pass away. Over the past few months my father has deteriorated and is bed ridden. We did arrange for him to have a day pass from the hospital to enjoy one more visit to our lake house which he loves. Paramedics and ambulance was used for this wonderful day for him. I was only sorry that I couldn't be there to enjoy the time with him<
> . I am hearing that my father doesn't eat much and he sometimes goes back to earlier years and asks about people who are no longer around. The next minute he is alert and knows what is going on. The hospital where he is at has been quarantined a couple of times due to SARS. While I was at the hospital over Christmas I spent time talking with my father and he would make comments like if he took this tube out he would just go to sleep and it would all be over. Is this true? No pain, nothing? He has lately had a temperature and they have put him in a room by himself, they check for SARS and he doesn't have this. Is this temperature part of the process he goes through before the end. I also understand that the average life span if you are on dialysis is @ 5 years. I'm hoping this all makes sense, it is very hard to be at a distance from your family in times of need (on all parts) <
>

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: Fri Jun 20, 2003 5:26 am    Post subject: End of Life issues    

It doesn't sound like your father has decided to stop dialysis, or at least your post does not make that clear.<
><
>If your father has decided to stop dialysis due to his deterioration and poor quality of life, then in my experience dialysis is stopped, hospice is involved and everything possible is done to keep the patient comfortable and pain free during the last days. The waste products build up fairly quickly depending on what he eats, and death is usually within 3-5 days. It is probably one of the most comfortable and pain free way to go.<
><
>It is unusual for a patient to be in a hospital as long as you say your father has been. Canada may be doing something different and you may need to ask why this is happening. But your father needs to make his decision or if he is not able to, then his wife will need to do so if she is able. If no one is willing to make any kind of decision, then maybe a care conference with his Dr. the family and other caregivers needs to be scheduled so that information can be shared and a plan that all can agree on can be formulated and carried out. Prolonging a persons suffering is a horrible way to live if you want to call it that.

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patient



Joined: 29 Oct 2002
Posts: 137

   
PostPosted: Fri Jun 20, 2003 9:19 am    Post subject: lower sodium    

I read where a patient said he ran on 140 sodium, but he got too thristy inbetween txs so he had his neph lower his sodium to 138. He said this also
ought his conductivity down lower, but he felt much better. <
>I would like to try this but when my cond. runs lower than 14.1 I feel crampy. If my sodium is lowered should the lower cond. (13.8-9) affect me?

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: Fri Jun 20, 2003 1:44 pm    Post subject: Patient    

Yes, it could affect you. If you feel crampy at 14.1, then it may not be a good idea to go lower as you

 may end up with sever cramps. What works for one patient does not always work for another. Listen to your body, it is trying to tell you that it doesn't like a lower condo or sodium. If you are using a sodium modeling program, then you could try just doing a straight 140 throughout your run. But don't go lower unless you discuss this with your Dr. If you run low BP's during your run, esp the last hour, then you may end up crashing.<
>If you want to decrease the amount of sodium in your diet, then consult with your dietician for more ideas and limit foods that are high in sodium. This will help decrease your thirst.

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Isabel



Joined: 11 May 2003
Posts: 25

   
PostPosted: Fri Jun 27, 2003 5:05 am    Post subject: Preventing Infections    

<
> I would like to know more about the type of infections dialysis persons are more susceptible and how can be prevented. Thank you!

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Founding RN



Joined: 10 Jan 2003
Posts: 172

   
PostPosted: Fri Jun 27, 2003 5:12 am    Post subject: Infections    

Isabel,<
> Dialysis patients can get any type of infection that anyone else can get. Dialysis patients are more prone to getting an infection than a healthy person is. The most common infections we see are those related to access, kidney, and bladder. <
> The best pervention is to wash your hands often, good personal hygiene, and for your access, wash the arm throughly with soap and water before needle punctures. If using a catheter, then make sure that the dressing over it it always clean and dry, changing it immediately if it gets wet. Also make sure that the dressing gets changed at every dialysis appointment. The staff must wash hands before doning gloves, wear a face mask and clean per the units protocol. <
>This will not prevent all infections, but it sure cuts down on them. If you suspect an infection, call you Dr. right away. Don't waitas it will take a lot longer to get over it if you do. Hope this helps.

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jewel335



Joined: 06 Oct 2005
Posts: 2

   
PostPosted: Thu Oct 06, 2005 12:11 pm    Post subject: Recall    

[quote:046bd5e37e]It is normal to feel those things after dialysis. Taking off extra fluid and waste products in a short amount of time makes one feel bad. Most patients get used to it after a while.[/quote:046bd5e37e]

When was it called back? :evil:

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PostPosted: Mon Feb 06, 2006 11:42 am    Post subject: Setup & initiate dialysis    

Since most centers have switched to useing a new dialyzer each treatment do they insert 10cc of patients blood into lines and let it circulate through the lines and dialyzer?

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Guest
   
PostPosted: Mon Feb 06, 2006 3:15 pm    Post subject: ??    Reply with quote
I am not sure what you mean. They cannulate and then attach lines to machine. Have not noticed them do anything different since the switch to non-reuse
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Guest2
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PostPosted: Thu Feb 09, 2006 6:54 am    Post subject: Explanation    

After the machine has done it's normal recirculation cycle they draw 10cc of blood and put it into the arterial med line. This then circulates through the tubing and dialyzer.

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Guest2
Guest





   
PostPosted: Thu Feb 09, 2006 6:56 am    Post subject: Explanation    

They cannulate for dialysis after the blood has had a chance to recirculate through the lines for 5 to 10 minutes.
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