Dialysis Basics: NCLEX Priorities
Hemodialysis vs peritoneal dialysis: how each works, fistula care, peritonitis signs.
Dialysis comes in two main flavors. NCLEX tests access care and complications.
Hemodialysis
3×/week, 3-4h sessions. AV fistula preferred access (mature 8-12 weeks). Auscultate bruit, palpate thrill. No BP, IV, or blood draws on fistula arm. Hypotension common during/after dialysis.
Peritoneal dialysis
Home-based. CAPD (continuous) or APD (automated overnight). Peritonitis is main complication, cloudy effluent, abdominal pain, fever. Treat with intraperitoneal antibiotics.
Comparison
HD: more efficient, requires center visits, hemodynamic shifts. PD: home flexibility, gentler, infection risk.
Diet on dialysis
Higher protein (lost in dialysate). Continued K+, phosphate, sodium restriction. Fluid restriction based on residual urine output.
Frequently asked
BP med before HD, give?
Often held, risk of intradialytic hypotension. Per facility protocol.
Fistula vs graft vs catheter?
Fistula best (lowest infection). Graft second. Catheter highest infection but used when others unavailable.
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