I have a new PD patient keep having negative UF 24H urine output <500mL and became fluid overloaded after5 days had to do 1 time back up hemodialysis (he still has a fistula/had been on ICHD for 2 years) , days after I check and did an initial membrane test and resulted to high transport type (cant do PET yet he barely started) , decreased dwell time around 1.5 hours 2 days after changes reviewed treatment still every cycle he has about 3/5 cycles still negative UFs, I had removed last fill on the second prescription change that I did because that made this pt overloaded and absorbs it after long day dwell, what prescription would you recommend?
ANSWERED Kimberly Flores answered April 22, 2022
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 In our home program, we have been practicing IP antibiotics administration for treatment for peritonitis on our PD patients. We have a new supervisor that is saying that we are not allowed as nurses to mix Abx with dianeal solutions and should be done by pharmacist. She has minimal experience with PD– performing exchanges for patients in an acute setting in the hospital. Has anyone ran into any of these issues before? Where can we find the answer and or source to show her that this is allowed practice?
ANSWERED Mary C answered April 6, 2022
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 Baxter Healthcare recently sent out an Urgent Medical Device Correction notification (Jan 2022) regarding the MiniCap Extended Life PD transfer sets and the use of cleaning products causing damage if come into direct contact (hand sanitizer, hydrogen peroxide, bleach, alcohol, or antiseptic agents, solvents used to remove adhesive residue). It has been our policy to cleanse the exterior portion of the transfer set prior to connection and disconnection with Alcavis. Due to the recent notification we have stopped this practice but are hoping to find out what others are doing in replace of this practice. We have been told Povidone Iodine or soap and water are both acceptable to clean the transfer set and catheter. Patients that shower daily, this can take place while in the shower but what about the patients that are not bathing daily, what would be an alternative to cleaning the transfer set and catheter? Any thoughts or suggestions would be greatly appreciated.
ANSWERED Carla M. answered February 1, 2022
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 Hi, I have a patient with severe intellectual impairment who has ESRF and embarking on RRT. Swimming is enjoyable activity for this young man . His mum will be doing his dialysis and thought of doing HD is very overwhelming for mum. I wanted to know what are the recommendations around swimming and PD, once the exit site has healed. he will be swimming in both public and private pools. Is it an absolute contraindication? Can it be pursued with use of colostomy bags and meticulous exit site cares. Thanks for letting me know. Reshma
ANSWERED Reshma Shettigar answered August 24, 2021
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 My name is Petra Janasova- I work as a station nurse in the Department of Pediatric Nephrology at the Motol University Hospital at the 2nd Medical Faculty of Charles University in Prague. In the care of our doctors and nurses, patients are also dependent on peritoneal dialysis. I have been trying for some time to find out if someone has ever developed a standard of care for a peritoneal catheter – I am interested in the procedure of catheter dressing, care for it since its introduction to the patient. In the Czech Republic, a similar standard of nursing care (guideline) does not yet exist. The information I found on the internet is very strict. Can I ask you for information about peritoneal catheter care as you practice it in your medical facility? Thank you very much. Mgr. Petra Janasova
ANSWERED Petra Janasova answered April 19, 2021
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 I have a patient with bilateral patent processus vaginalis which was accidentally discovered while performing urgent-start PD and the caregiver placed him in an upright position which led to scrotal edema. The finding was confirmed by CT peritoneography. He underwent bilateral inguinal herniorrhaphy and currently shifted to hemodialysis. Is it safe to resume PD 4 weeks post-surgery? When resuming PD, should I start low fill volumes and shorter dwell time? Can I placed him right away to CAPD? Thank you
ANSWERED MARY ROSE BISQUERA answered April 19, 2021
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 When connecting drain tubing to the PD catheter with a povidone iodine cap, is it necessary to soak the catheter connection or tip in antiseptic prior to connecting the tubing? Or is a no touch technique superior when the catheter has an antiseptic soaked cap? The latest Lippincott procedure instructs to soak the catheter tip in an antiseptic soaked gauze for 5 minutes before connecting the tubing. I understand cleaning the catheter with the cap still on prior to removing the cap and connecting to the tubing, but I can't find any rationale for doing this extra step of soaking the catheter tip.
ANSWERED Angela N answered April 15, 2021
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 I have a patient on Hemodialysis short term due to polymicrobial peritonitis requiring catheter removal. Patient is on maintenance warfarin but bridged over to Lovenox for insertion of new PD cath. Post op day 10 patient felt unwell, weak, SOB. Hemoglobin was 65 (INR 5.3) and patient was determined to have hemoperitoneum. CT has shown no active bleed and after 4 units PRBC's, hemoglobin has remained stable. Over a number of days we have drained a total of 3.5L blood from peritoneum through patients PD cath. Wondering if you have any recommendations. Should we be draining hemoperitoneum? When we determine it is fully drained is it ok to restart PD? Thank you.
ANSWERED JENNIFER,H answered April 2, 2021
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