The Basics of Hemodialysis
This information at be overwhelming and hard to remember at first so you will have this available at anytime and always feel free to ask any questions.
What exactly the Hemodialysis Process is and the steps
Important Safety Considerations
So go ahead and start exploring and learning!
What is Hemodialysis?
The basics of how Hemodialysis works is blood from an artery will go through a small device, called a dialyzer which filters the blood and the blood flows back into the body free of wastes.
Below is a picture of what the Hemodialysis system looks like... (From Medbroadcast.com)
Hemodialysis Step by Step
2. Before beginning the process your nurse will assess the AV fistula and make sure she feels a vibrating sensation and hears a swishing sound, this means that the device is working and ready to use (Pellico, 2013).
3. Two needles will be inserted into the AV fistula, one needle carries the blood to the dialyzer and the other brings the blood back into the body (Pellico, 2013).
4. When the blood is in the dialyzer it is mixed with a liquid called Dialysate, which helps with the filtering process. Once the blood is filter it goes back into the body through the other needle.
Teaching about AV fistula
2. Do not allow blood to be drawn from that area
3. Do not allow an IV inserted and BP taken on the arm with the device
4. Avoid wearing tight clothing or carrying bags on the side of the device
5. Do not lie or sleep on the area
6. Look at the site daily- looking for redness, heat, pain, swelling, drainage
7. If any of the things listed on #6 is found report to health care provider
Before Hemodialysis- Key Assessments
1. Checking the AV fistula
- feeling for a vibrating or buzzing filling
- listen for a swishing sound (using a stethoscope)
2. Assess the site for redness, swelling, bleeding, heat or pain and bleeding
3. Baseline Vitals- heart rate, blood pressure, temperature, oxygen saturation
4. Record Weight
During this time you will be monitored by a nurse, who will be making sure that everything is running smoothly.
The nurse will be assessing-
1. Vital signs- blood pressure and pulse
3. Asking you how you are feeling
4. And make sure that the machine is working properly
5. Monitoring for an adverse reactions- chills, fever, chest pain, itching
Key nursing assessments-
1. Re check vital signs- blood pressure, heart rate, temperature, oxygen saturation
2. Re check weight
3. Review lab results
4. The nurse will ask you if you are experiencing headache, nausea and vomiting or feeling different at all.
5. Assess the AV fistula site- looking for bleeding
Some common post hemodialysis symptoms you may have are-
-Low or high blood pressure
- muscle cramps
- trouble sleeping
(Mayo Clinic, 2015).
Ways to Reduce Side Effects
- Rest when needed!!
- Do a activity then rest
- Try not to sleep during the day, so that you are more likely to sleep at night
- Join a support group- it can be helpful to talk with people who are going through the same thing
- Ask for help when you need it
The Hemodialysis Diet
By following this diet it will help the dialysis treatment be more effective, help you feel your best and reduce more complications with your kidneys (Pellico, 2013).
Foods Choices you can have
French, Italian, Raisin, Light Rye or sourdough bread ( 1 slice or small dinner tole)
Cream of rice, cream of wheat or cooked grits
Cooked pasta (1/2 cup)
Plain popped popcorn
Unsalted pretzel sticks
Vegetables- 1 servering is 1/2 cup
Raw cabbage, eggplant, cauliflower
All varieties of lettuce
1 stalk of raw celery
Fresh and canned mushrooms
The following are vegetables that are a little in potassium-
Broccoli or celery
Green or snow peas
Summer squash or zucchini
Fruits- severing size if 1/2 cup
Apple juice, applesauce or small apple
Grapes, grape juice
1/2 of milk
1/2 cup of plain or fruit flavored yogurt or ice cream
1 slice of cheese
Cooked beef, pork, poultry
Fresh of frozen fish, tuna, shrimp, lobster
Whole egg or egg whites
1 teaspoon of margarine or mayo
1 teaspoon of oil- sunflower, corn, soybean, olive, peanut, canola
1 tablespoon oil based salad dressing
Non- cola sodas
Water or mineral water
Lemonade or limeade
Foods to avoid
Dried Peans and peas
Avoid adding extra salt to foods
Avoid processed meals and fast food
Dried fruits and beans
Macaroni and Cheese
Helpful Resources related to Diet
This other website has a complete list of suggested foods and foods to avoid, which can be helpful to use when grocery shopping-
Kidney Friendly Recipe Websites
Below is a list of some websites that contain some great recipes that follow the guidelines of a Hemodialysis diet
So here are some helpful tips on how to deal with fluid restriction-
- Have some ice chips
- Freeze some fruit juice and then use them as ice chips
- Chill fruits
- Have some sour candy
- Have some lemon or lime slices
- Use mint or basil in foods or drinks to refresh mouth
- Avoiding salt and caffeine will help decrease thirst
Here is great website that has some tips on reducing drinking-
You are having trouble with cutting out alcohol talk with you nurse, they can help set you up with a program and offer additional support.
How to fit Hemodialysis into your lifestyle
1. having a ride to and from treatment center- you will be extremely tired after
2. coming up with a plan on how to complete all daily tasks that you want to get done
3. Am I going to work?
4. Do I have a support system? How will this affect my relationships?
5. Changing my diet to follow the hemodialysis diet and restricting my fluid intake
6. Limiting my alcohol intake
7. Stop smoking
8. To maintain a healthy life style
Ways to prevent infection
- Hand washing frequently!!
- Staying away from people who are sick
- Carrying hand sanitizer on you at all times
- Staying away from crowds
- Disinfect/ sanitize any object you are going to touch
It best to get active in time sections of 15-20 minutes, and you always want to stop if you are feeling pushed or too tired... You do not want to wear yourself out to much.
Going for a walk around the house/ outside
Riding a bike
Playing with your dog
Playing with your children
You can basically do any active you would like as long as it is not over straining and you limit the time you spending doing it!
The Renal Diet. Little Rock: Hospital, 1973. The Renal Diet. VCU Health System, 2015. Web.
Pellico, Linda Honan. Focus on Adult Health: Medical-surgical Nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013. Print.