Peritoneal Dialysis: What You Need to Know

Setting 

Peritoneal dialysis is a procedure that is used for the treatment of kidney failure which cleanses an individual’s blood from the lining of a person’s abdomen. A patient should set up their dialysis area before ensuring that their hands are clean (Haggerty et al., 2014). Additionally, ensure that the windows are closed and the room well ventilated. The area should be lit properly devoid of any distractions that would flaw the process (Haggerty et al, 2014). An individual should then ensure they comprehend the process of selecting the most ideal dialysis solution. The patient should then perform the procedure, while ensuring that both the dialysis bag and the exit point are taken after. 

Purpose 

Peritoneal dialysis is performed in order to prevent the accumulation of waste fluids, minerals and excess water in an individual’s body in the case that an individual suffers kidney failure (Griva et al., 2013). Additionally, dialysis is performed so as to assist in controlling blood pressure in addition to ensuring that bodily fluids maintain an optimal level of acidity for proper functioning of the body (Griva et al., 2013). PD also provides a convenient and natural way for the body to offset the imbalance in electrolytes of the body. 

Pre-intra and immediate post procedure care 

An individual should ensure that sterile equipment is used during procedures in order to prevent the risk of Peritonitis which is closely associated with the peritoneal dialysis procedure (Haggerty et al., 2014). An individual should additionally prime the tubing with solution to allow for free flow of the solution in addition to preventing incidences of a leak or a contamination (Haggerty et al., 2014). Immediate post procedure care encompasses assessment of vital signs which include blood pressure, temperature by comparison of the pre-dialysis levels with the post-dialysis analysis of the aspects (Haggerty et al., 2014). All the dialysate fluid should be disposed into the toilet. Immediately after the procedure, an individual should clean their peritoneal dialysis catheter exit site (Haggerty et al., 2014). This will ensure that the patient does not suffer from infection or complications arising from poor hygiene during the process of dialysis, especially having in mind that the fluids extracted are filled with toxins and impurities. 

Ongoing post-procedure care 

Vital signs of patients are continuously assessed to ensure that the patient recovers after the performance of the PD procedure (Makhija et al., 2018). Furthermore, patients are given vitamin supplements given the fact that some vitamins which are soluble are at times extracted by dialysis therefore leaving the body with a deficiency of vitamins (Makhija et al., 2018). To add on this, post-procedural care also involves the ascertainment of the hydration state of an individual (Haggerty et al., 2014). This is given the fact that the wrong choice of a dialysis fluid in preference for a solution that is too concentrated would result in dehydration of an individual. 

Documentation 

In the documentation of clinical procedure, (Subjective, Objective, Assessment, Plan) SOAP documentation is critical given the fact that it is problem-oriented therefore allowing a healthcare professional to identify a patient’s health concerns (Makhija et al., 2018). The Subjective data for the case is that the patient is experiencing a reduced amount of urine, persistent incidence of nausea, excessive fatigue upon completion of simple tasks in addition to difficulty in breathing. Considering the objective data of the case, a physical exam revealed gross chemical imbalance in the body in addition to an imbalance of electrolytes in the body. Assessment of the patient’s symptoms in addition to the vital signs points to the fact that the patient suffers from kidney failure. The plan adopted in the case scenario would be to perform a PD to ensure that the body resumes normal functioning. 

References 

Griva, K., Lai, A. Y., Lim, H. A., Yu, Z., Foo, M. W. Y., & Newman, S. P. (2014). Non-adherence in patients on peritoneal dialysis: a systematic review.  PLoS One ,  9 (2), e89001. 

Haggerty, S., Roth, S., Walsh, D., Stefanidis, D., Price, R., Fanelli, R. D., ... & SAGES Guidelines Committee. (2014). Guidelines for laparoscopic peritoneal dialysis access surgery.  Surgical endoscopy ,  28 (11), 3016-3045. 

Makhija, D., Alscher, M. D., Becker, S., D'Alonzo, S., Mehrotra, R., Wong, L., ... & Sloand, J. A. (2018). Remote monitoring of automated peritoneal dialysis patients: assessing clinical and economic value.  Telemedicine and e-Health ,  24 (4), 315-323.