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Hemodialysis

Terms

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Homeostasis
The constant balance of processes in the body.
Hypo-
Low
Hyper-
High
Acute Renal Failure
Sudden loss of renal function that is reversible.
Chronic Renal Failure
Slow, progressive loss of renal function that is not reversible.
Anemia
Low red blood cells.
Uremia
Urine in the blood due to the build up of toxins.
Symptoms of Uremia
  1. Anemia
  2. Bone disease
  3. Pericarditis
  4. Electrolyte imbalance
  5. Neuropathy
  6. Amyloidosis
  7. Carpal Tunnel Syndrome
  8. Itching
  9. Sleep problems
  10. Bleeding abnormalities

True or False:

Kidneys fail when they lose filtering capacity in the nephrons. 

True
Kidney filter about _____ liters of fluid from the bloodstream and _____ of that become urine.
  1. 180
  2. 1-2L

True or False:

The tubules receive a combination of waste materials and chemicals that the body can still use. 

True
Functions of the kidney: 
  1. Fluid balance
  2. Removes waste products
  3. Acid Base Balance (pH and bicarb)
  4. Electrolyte balance
  5. Secretes Hormones
What makes up the electrolyte balance?
  1. Na+
  2. K+
  3. CA 2+
  4. MG 2+
  5. Bicarb H2CO3
Hormones secreted by the kidney:
  1. Renin
  2. Erythropoietin
  3. Activated Vitamin D
2 major causes of kidney failure:     
  1. Diabetes
  2. Hypertension
Dialysis
Process of diffusion and ultrafiltration that replaces the function of the kidney.
Semi-permeable membrane
A barrier that allows only particles smaller than a certain size to pass through it.
Diffusion
The movement of a solute through a semi-permeable membrane from area of high concentration of solutes to an area of low concentration of solutes.
Osmosis
Movement of fluid through a semi-permeable membrane from an area of low concentration of solutes to an area of high concentration of solutes.
Ultrafiltration
Water removal from blood due to a pressure gradient across a semi-permeable membrane.
Concentration gradient
Difference of concentration on either side of the semi-permeable membrane. 
Clearance
How well we are cleaning the blood.
Transmembrane Pressure (TMP)
Difference in pressure between blood compartment and dialysate compartment.
Biocompatible
When the diayzer is similar to the human body.
Conductivity
Ability of a fluid to conduct electricity.
Blood Flow Rate (BFR)
The rate that we pump the blood through the blood pump.
Ultrfiltration Goal
How much fluid we want to take of.
Ultrafiltration Rate
How fast we move the fluid.
Ultrafiltration Removed  
Actual fluid removed.
Counter-current flow
Opposite flow of  fluids which increases rate of diffusion.
Extracorporeal circuit
tubing, needles, and ect. that extends the bodies circuit circulation.
Blood leak detector
Alerts us that blood is leaking.
Air detector
Sensor that detects air in the venous drip chamber.
Bypass
Something wrong with dialysate and the dialyzer and it dumps if down the drain.
Dialysate Composition
Treated H2O, K+ and H2CO3
Compartments of dialyzer
Dialysate and blood compartment.
Solution used to prime dialyzer
0.9% NaCl
What can affect the rate of diffusion?
  1. BFR
  2. Dialysate rate
  3. Tempature
  4. Surface area
  5. Counter current flow
  6. Alarms
Hepatitis B
This infectious disease requires isolation of the patient and isolation techniques.  It has a high concentration in the blood and can live outside the body 7-10 days.
Hepatitis C
#1 cause of liver failure/transplant: also known as non A non B
TB
This illness requires a specialized isolation room with reverse air flow.  It is an air borne infectious disease.
HIV
Virus that gradually weakens the immune system.  It is carried through the blood.
Antigen
An active virus.
Antibody
Built up protection from a virus.
Type I diabetes
Immune system destroys the insulin-producing cells in the pancreas.
Type II diabetes
Body does not produce insulin or does not know how to use it.
Hypoglycemia
Low blood sugar.
Symptoms of Hypoglycemia:
  1. Sweating
  2. Trembling
  3. Restlessness
  4. Loss of consciousness
  5. Headache
  6. Feeling cold
  7. Rapid heart rate
4 treatment options for ESRD;
  1. Hemodialysis
  2. Peritoneal Dialysis
  3. Transplant
  4. No treatment
The 2 main waste products removed by the normal kidneys:
  1. BUN (Blood Urea Nitrogen)
  2. Creatinine

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