Answer to Question 1
There are two main types of peritoneal dialysis (PD):
Continuous ambulatory peritoneal dialysis (CAPD)
Continuous cycling peritoneal dialysis (CCPD)
In peritoneal dialysis, access to the patient's blood supply is gained via a catheter of silicone rubber or polyurethane, placed surgically into the peritoneum.
In this procedure, dialysate is introduced into the peritoneum through the peritoneal catheter.
Solutes from the plasma circulating in the vessels and capillaries perfusing the peritoneal wall pass across the peritoneal membrane into the dialysate, which is subsequently removed and discarded.
Due to the use of dextrose in the peritoneal dialysate, and its dwell time within the peritoneal cavity, PD will provide calories to the patient and should be accounted for when assessing for nutrition therapy
Hemodialysis attempts to mimic the filtration function of the body.
Dialysate fluid is designed to be similar to human plasma.
The patient's blood is pumped through a capsule of microscopic semipermeable membranes over several hours.
This is repeated approximately three times each week.
Using the concept of diffusion or osmosis, waste products are pulled from the blood into the dialysate.
Composition of the dialysate is determined by patient's individual laboratory parameters, and can be adjusted to osmolality and electrolyte content.
Answer to Question 2
Increasing BUN, increased creatinine, edema, and decreased urine output (cloudy, amber urine/GFR of 8 mL/min/1.73m2).
An example of a late entry to the medical record.
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