1. AV Fistula
    connect artery and vein for heme
  2. AV graft
    External Shunt
    Internal AV graft
    • looped graft internally between vein and artery
    • external segment
    • anastmosis of artery and vein, shunting arterial blood into vein
  3. Hemed effectiveness measured by
    fluid, solute, and urea removed from body
  4. Peritoneal dialysis
    • dializing solution through catheter, remains for 1 h +, then removed.
    • -catheter into abdomen in hc setting
    • -implanted cath every night at home
  5. Potential complications
    avoid what foods?
    • Electrolyte imbal, bleeding at cath site, cardiac ischemia, irreg hb, air emblysm, anemia, htn, pulm edema, hf, fluid accumulation, pericarditis, hyperkalemia, bone disease, hypocalcemia, periph neuro, pneu, sleep dis, vitamin D def, anxiety depression.
    • -avoid excessive fl intake, salt, phosph rich foods, (cheese milk beans nuts p butter, dark cola, potassium-kiwi, dried fruit, banana, avo) antacids and lax
  6. Osmotic diuretics names
    Osmitrol mannitol
  7. Osmotic diuretics used for
    • edema, intra oc pressure k function in ARF
    • IV only
  8. Osmotic diuretics
    How do they work, where do they work, side effects?
    • increase plasma osmotic pressure, proximal convaluted, elevates glom titrase, dec cerebral edema,
    • se's pulm edema, renal f, extrav, fl imbal, hypotension
  9. what are sx of hyper AND hypokalemia?
    • EKG changes
    • dysrhythmias
    • muscle weakness
    • flaccid paralysis
    • cardiac arrest
  10. What are only signs of hypokalemia?
    • diminished DTR
    • hyporeflexia
    • leg cramps
    • polyuria
    • Think- not enough K+ to have dtrs, reflexes, keep leg from cramping, and you're peeing all of it out
  11. What are only sx of hyperkalemia?
    • Irritability
    • peaked T waves
    • V/V/D (think too much, so overflowing K+)
    • numbness and tingling
    • anuria
    • -think- you are full of K+ because you can't pee it out and are so full you are numb and tingling and throwing up and even your T wave is high
  12. What are sx of both hyper and hypocalcemia?
    • confusion
    • N/V
    • cardiac dysrhythmias
    • cardiac arrest
  13. What causes hypocalcemia?
    citrate, booze, alkalosis, CRF, anticonvulsants, diuretics, def of PTH, def of Vitamin D, Increased Mg, thy surg, burns, low albumin
  14. Hypocalcemia
    4.5-5.2 or 8?
    • anxiety
    • irritability
    • osteoporosis
    • tingling
    • twitching
    • muxcle spasms of hands and feet
    • tetany
    • diarrhea
    • hyperactive dtr
    • ca deposits in body tissues
    • laryngeal spasms
    • You don't have enough bone so your muscles are freaking out and reflexes, you have deposits in body tissues not where they're supposed to be, and you can't even swallow
  15. Hypercalcemia- causes?
    multiple myeloma, high intake ca and antacids, inc pth
  16. What are only sx hypercalcemia?
    • anorexia
    • constipation
    • paralytic ileus
    • polyuria
    • renal stones
    • decreasedd dtr
    • decresed muscle tone
    • lethargy and coma
    • Think- so much bone that nothing else is working, dtr, muscles, think of trying to pee out extra bone and trying to pee out bone
  17. Hypermagnesemia
    • hypotension, vasodilation, heat, thirst, NV, loss of dtr, resp depression, hypotension
  18. Hypomagnesemia
    • anorexia, mental changes
    • tremors
    • arrhythmias
    • seiz, cramps, tetany, dysphagia
  19. -Thiazides, how often given and for what?
    -Where do they work?
    -how do they work?
    • -most common, mild HTN and systemic edema
    • Chlorothiazide, Hydrochlorothiazide (often w ACE), Metolazone (zaroxolyn),
    • -early distal convoluted
    • -impair Na Cl reab, leads to excr ofwater and elytes
    • -hypokalemia, alkalosis, not effective in renal disease hold for hypotension
  20. K+ sparing diuretics, names?
    What for?
    How do they work?
    where do they work?
    • Spironolactone, aldactone,
    • Used to limed to limit K wasting of other Diuretics
    • Inhinit salt reabsorb and K secretion
    • distal convoluted
    • Hyperkalemia, aces an add to this, ASA can inc diuretic eff, can inc digoxin
  21. Loop diuretics, names?
    • Lasix/furosemide
    • Nephrotic synd, CHF, CRF, pulm edema, hepatic cirrhosis
    • most potent, anble to move large volumes quickly through kids by inhib tubular reab of Na and Cl
    • SEs- hypokalemia, and other elytes, hypochloremic alkalosis, dehyd, vertigo, hypotension, circ collapse
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