Treatment Procedures

HemodialysisA procedure which involves removing waste

products such as creatinine and urea, as well as free water from the blood when the kidneys are in renal failure.

The blood is routed outside the body into a dialysis machine via tubes and then back inside the body.

ProcedureBaseline vital signs taken for referenceAccess point is establishedPatient is connected to the dialysis machine

in a closed loop circuitBlood is pumped from the body into the

dialysis machineBlood is pumped back into the body after

cleansingVital signs are taken at set intervals to

monitor client’s condition

PreparationAccess method is determined.

Arteriovenous FistulaArteriovenous GraftCentral Venous Catheter

Patient is weighed. Vital signs taken and recorded.

PrecautionsComplete History must be taken into accountRisk for infectionBlood pressure instabilityDizzinessNausea and VommitingFatigueFirst Use Syndrome

Nursing ResponsibilitiesVerification of Doctor’s ordersProper client identificationProper client education about the procedure

and it’s uses and effectsSecure client consentProper vital signs monitoringMaintenance of AsepsisPatient safety

Peritoneal DialysisDialysis method that uses the client’s

peritoneal membranes in the filtration and diffusion process of cleansing the client’s blood from waste products

Cheaper than Hemodialysis

ProcedureAccess point is establishedDialysate is infused into the peritoneumAfter a set period of time, the dialysate is

drainedThe volume drained is compared to the

volume infused and noted properly

PreparationAccess point is establishedSterility is ensured and maintained

PrecautionClient’s dietRisk for Infection and PeritonitisHypovolemic shockEdemaHyper and HypotensionDifficulty of breathing

Nursing ResponsibilitiesVerification of Doctor’s ordersProper client identificationProper client education about the procedure

and it’s uses and effectsSecure client consentProper vital signs monitoringMaintenance of AsepsisPatient safety

CystoclysisA continuous infusion of a sterile solution into

the bladder, usually by using a three-wayirrigation closed system with a triple-lumen catheter.

One lumen is used to drain urine;another is used to inflate the catheter balloon, and the final lumen carries the irrigation solution.

CBI is primarily used following genitourinary surgery to keep the bladder clear and free of blood clots or sediment

ProcedurePosition client for access of cathetersSet up irrigating solutions and prime tubingSet up catheter drainage bagInfuse irrigating solution into the bladderNote Input and Output variations and adjust

to obtain correct client output

Preparation3-way catheter is insertedMaintain sterilityEnsure that urine is being freely drained

before starting irrigation

PrecautionInfectionsBladder distentionBladder rupture

Nursing ResponsibilitiesVerification of Doctor’s ordersProper client identificationProper client education about the procedure

and it’s uses and effectsSecure client consentProper vital signs and I&O monitoringEnsure free drainage of urineMaintenance of sterilityPatient safety

Central Venous PressureDescribes the pressure of blood in the

thoracic vena cava, near the right atrium of the heart.

CVP reflects the amount of blood returning to the heart and the ability of the heart to pump the blood into the arterial system.

ProcedureAn incision is made usually on the client’s upper armA suitable vein is located for the insertion of the catheterThe catheter is threaded aseptically into the veinThe catheter’s distal tip must rest at the point where the superior

vena cava joins with the right atrium of the heartTo read, a 3-way tap is used to connect the manometer to an

intravenous drip set on one side, and, via extension tubing filled with intravenous fluid, to the patient on the other

3-way tap is manipulated so that the path open is from the fluid bag to the manometer and closed to the patient. Fill manometer to adequate amount

3-way tap is manipulated so that the path is open from the manometer to the client and closed to the fluid bag. The fluid in the manometer will drain into the patient and will stop at the point where CVP is currenty at

PreparationMaintain sterility