HEMODIALYSIS

-is the most common treatment for chronic kidney failure (end-stage renal disease). The
procedure cleanses the blood of wastes and excess fluid (such as potassium and urea) after the
kidneys can no longer perform these functions.

Most people receiving hemodialysis go to a clinic called a dialysis center, usually three times a
week. Each dialysis session may last from three to five hours.

Who needs this procedure?

People whose kidneys no longer function as they should require hemodialysis. Loss of kidney
function can be caused by disease, a traumatic injury, drugs or poisons, or an obstruction of the
urinary tract.

o In hemodialysis, your blood is allowed to flow, a few ounces at a time, through a special
filter that removes wastes and extra fluids. The clean blood is then returned to your
body. Removing the harmful wastes and extra salt and fluids helps control your blood
pressure and keep the proper balance of chemicals like potassium and sodium in your
body.

How do I prepare for this procedure?

 Once the decision is made to begin hemodialysis, your doctor or a dialysis specialist will
explain the procedure to you.

 The doctor will identify the area where the blood will be removed from a vein and
returned, called the access site.

 Your blood pressure, temperature, and weight will be checked right before each
hemodialysis treatment. Your “before” weight will be compared with your weight after
treatment to make sure you are not retaining too much fluid.

 You may be given an injection of a drug that prevents blood clotting, called an
anticoagulant, so your blood flows freely through the hemodialysis machine.

How is this procedure performed?

 You can sit up and remain fully alert while receiving hemodialysis.

 Two needles are usually inserted, one to remove the blood from the vein, and the other to
return the blood.
  The blood flows through plastic tubing to a filter called a dialyzer. A dialyzer works
somewhat like an oil or fuel filter in a car. It consists of many small fibers that collect the
waste products and extra fluids that your kidneys are unable to filter from the blood.

 The dialyzer is surrounded by a fluid called dialysate. Dialysate is a chemical solution

that takes the wastes and extra fluids trapped by the dialyzer and carries them away from
the blood.

 The dialysate also contains electrolytes and other chemicals that your body needs to
maintain in a careful balance in order to function properly. These are added to the
purified blood, which is then returned to your body through the second needle.

Summarize:

The patient’s blood is pumped into the dialysis machine.

Blood passes through the fibers and into the dialysis solution.

Chemicals in the solution absorb the impurities and excess fluids from the blood.

The solution carries away the impurities.

Clean blood is returned to the body.

Note:

 Common side effect:

Øfatigue due to anemia (insufficient red blood cells)

Ø uremia (toxins in the blood that hemodialysis does not completely remove or that build up
between treatments).

Ø Low blood pressure

Ø Chest pain

Ø Leg cramps

Ø Nausea and headache

How Diet Can Help

Eating the right foods can help improve your dialysis and your health. Your clinic has a dietitian
to help you plan meals. Follow the dietitian's advice closely to get the most from your
hemodialysis treatments. Here are a few general guidelines.

 Fluids
 Potassium
 Phosphorus
 Salt (sodium chloride)
 Protein
 Calories
 Supplements

Nursing Responsibilities:

 Monitor patients’ vital signs before and after the procedure.

 Monitor weight before and during the procedure.

 To oversee and coordinate care, ensuring treatment and access of sites is done correctly
with safety checks done.

 Charting is correct and completed.

 Observe for ill effects and intervene as necesssary even if this means calling the
physicians.

Submitted by:

Buenaventura, Hayzel

Lazibal, Eva Christine

Makalintal, Ma. Theresa

Paduada, Kristine Joy

Viernes, Ninotchka
BSN III - C