Peritoneal dialysis research

Once the fluid is filled in the abdominal cavity, the catheter is capped to prevent any leakage of the dialysate. The dialysate fluid which usually consists of water and additives such as salts absorbs wastes from the blood through the peritoneum which acts as a semi-permeable membrane. The peritoneum allows wastes from the blood into the dialysate while retaining required substances into the blood (Mehrotra, Devuyst, Davies & Johnson, 2016). The dwell time (the time the dialysate has to sit in the stomach) is often determined by the amount of waste and size of the individual. However, the dialysate ought to be replaced after 2 hours to ensure optimal dialysis occurs. Patient education plays an important role in enabling the patient to participate in their care as well as building self-efficacy on self-administration of the peritoneal dialysis.

The patient education ought to incorporate the patient needs as well as the patient family or significant other needs. Patient education should include information on catheter care post insertion, the procedure for peritoneal dialysis, how to care for the entry and exit sites and procedure for completing the dialysis on their own. To achieve efficient patient education, the nurse should utilize visual presentations to enhance the patient’s ability to remember. Patient brochures are important so that the patient can refer for more information at a later date. The dressing on the catheter exit site should be assessed for; any signs of infection or risk for infection. The exit site assessment should include an assessment for any signs of infections such as excessive serous drainage on the exit site dressing, the presence of trauma (Shao et al.

The patient assessment will also assess the nutrition status of the patient to minimize the risk of constipation in the patient which might result in tipping of the catheter from the lower pelvis. Admission of prophylactic antibiotics is a crucial intervention to mitigate constipation in the patient as well as providing the patient with stool softeners to prevent constipation (Shao et al. The initial peritoneal dialysis cycle, the patient should be assessed on the effectiveness of the peritoneal dialysis in cleansing their bloodstream. Patient education during the procedure should be aimed at strengthening the patient’s understanding of the infection prevention intervention in peritoneal dialysis, monitoring of the adequacy of the ultrafiltration and education on the need for follow-up care adherence so as to ensure effective and safe peritoneal dialysis.

Documentation Following successful peritoneal dialysis, the patient documentation ought to ensure that it provides a correct description of the procedure and any identified complications, risks if any. The documentation should include the findings on assessment of the exit site with a description of its appearance with any significant findings indicated. Any noted signs of complications such as leakage, trauma, and infection should be documented. Documentation of the patient's self-efficacy in self-administering the procedure and any identified patient needs such as gaps in knowledge or skills should be documented. Assessment Laboratory assessment of the patient reveal elevated blood urea nitrogen, elevated serum creatinine levels and albumin levels. Plan Patient scheduled for a peritoneal dialysis with 4 exchanges to ultrafiltrate blood of the accumulated wastes.