The Basics of Hemodialysis

Welcome!

Here is some key information on Hemodialysis that you can review.

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.

Topics Covered

The Important Topics related to Hemodialysis that are covered in this flyer include-

What exactly the Hemodialysis Process is and the steps

Important Safety Considerations

Hemodialysis Diet

Smoking Cessation


So go ahead and start exploring and learning!

What is Hemodialysis?

Abby, you are going to be receiving hemodialysis because your kidneys are no longer functioning properly. This is because of the chemical accident at your work which caused damage to your kidneys. So hemodialysis works as artificial kidneys for you to remove toxins from your blood and remove extra fluid from your body (Pellico, 2013).


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)

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Hemodialysis Step by Step

1. Before the process can even begin we will need to gain access to your blood. This will first be done by inserting a catheter (a needle) into your subclavian vein, which is right by your clavicle (Pellico, 2013). If you will be getting hemodialysis permanently a device called an ateriovenous fistual will be surgically inserted. When dialysis is performed two needles will be inserted into the device and makes filtering the blood much easier (Pellico, 2013).


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.

The Very Basics of Dialysis

Teaching about AV fistula

1. Avoid compressing the area

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

(Pellico, 2013).

Before Hemodialysis- Key Assessments

Before Hemodialysis is before your nurse will perform some important assessments to make sure everything is ready.

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

(Pellico, 2013)

During Hemodialysis

The overall treatment takes about 3 to 5 hours (you will usually be getting 3 times a week).

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

(Pellico, 2013)

After Hemodialysis

After the process is done there are some things the nurse will check out before you can leave for the day.

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

Side Effects

There are some side effects that can come along with hemodialysis but there we want to help work with you to decrease them.

Some common post hemodialysis symptoms you may have are-

-Low or high blood pressure

- muscle cramps

- itching

- trouble sleeping

- fatigue

- depression

(Mayo Clinic, 2015).

Ways to Reduce Side Effects

- Pick and choose what straining activities you have to do

- 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

While on hemodialysis it is very important that you follow a certain diet to prevent complications. The Hemodialysis diet is based on restricting protein, sodium, potassium, phosphorous and fluid (Pellico, 2013). This can be a challenging adjustment at first but below is a help list of foods you can eat and then foods to stay away from.

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

Starches-

French, Italian, Raisin, Light Rye or sourdough bread ( 1 slice or small dinner tole)

Cereal

Cream of rice, cream of wheat or cooked grits

Cooked pasta (1/2 cup)

Plain popped popcorn

Unsalted pretzel sticks

tortilla chips

Vanilla wafers

shortbread cookies

Vegetables- 1 servering is 1/2 cup

Green beans

Bean sprouts

Raw cabbage, eggplant, cauliflower

All varieties of lettuce

Raw carrots

Cucumbers

Onions

Canned corn

1 stalk of raw celery

Fresh and canned mushrooms

The following are vegetables that are a little in potassium-

Asparagus

Broccoli or celery

Mixed vegetables

Green or snow peas

Summer squash or zucchini

Fruits- severing size if 1/2 cup

Apple juice, applesauce or small apple

Blueberries

Cranberrries

Grapes, grape juice

Canned peaches

Canned pears

Pineapple

Strawberries

Tangerine

Watermelon

Dairy-

1/2 of milk

1/2 cup of plain or fruit flavored yogurt or ice cream

1 slice of cheese

Meat-

Cooked beef, pork, poultry

Fresh of frozen fish, tuna, shrimp, lobster

Whole egg or egg whites

Fats-

1 teaspoon of margarine or mayo

1 teaspoon of oil- sunflower, corn, soybean, olive, peanut, canola

1 tablespoon oil based salad dressing

Liquids-

Non- cola sodas

Water or mineral water

Ice

Lemonade or limeade


(Drugs.com, 2015)

Foods to avoid

Bacon

Ham

Sausage

Cold Cuts

Dried Peans and peas

Peanut butter

Avoid adding extra salt to foods

Avoid processed meals and fast food

Dried fruits and beans

Potatoes

Tomatoes

Pizza

Cola

Pancakes

Macaroni and Cheese

Chocolate


(Dialyspa. com)

Helpful Resources related to Diet

Below is a great link that has some really helpful tips about the Hemodialysis diet if you would like some more information-


https://www.vcuhealth.org/transplant/docs/renal_diet.pdf


This other website has a complete list of suggested foods and foods to avoid, which can be helpful to use when grocery shopping-


https://www.vcuhealth.org/transplant/docs/renal_diet.pdf


Another resource- http://www.kidneyfund.org/kidney-health/brochures/brochure-pdf/healthy_eating_for_hemodialysis.pdf

Kidney Friendly Recipe Websites

Below is a list of some websites that contain some great recipes that follow the guidelines of a Hemodialysis diet


http://www.davita.com/recipes/


https://www.kidney.org/sites/default/files/docs/kidney_cookbook_lr.pdf


http://www.myspiceitup.ca

Fluid Restriction

One of the hardest parts of the Hemodialysis diet is that how much you can drink in a day is limited. This is limited because you are at risk for getting too much fluid in your body and high blood pressure (Pellico, 2013).

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

(Pellico, 2013).

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Limiting Alcohol

With any type of kidney damage it is important to completely stop alcohol consumption because if consumed it will cause further damage (Pellico, 2013). With hemodialysis it is key to limit or completely stop drinking alcohol because it can be dangerous and cause some serious problems.

Here is great website that has some tips on reducing drinking-

http://www.myspiceitup.ca


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.

Smoking Cessation

When starting hemodialysis you should stop smoking.. this can be a challenging thing to do but continuing smoking can be dangerous.


Here are some great links to provide information about smoking cessation- http://smokefree.gov


http://www.lung.org/stop-smoking/

How to fit Hemodialysis into your lifestyle

Hemodialysis is a commitment and it can be hard to adjust to this. Each week you will be going to get treatment 3 times a week for 3-4 hours, this is something you will have to plan for. Some things you should plan for are-

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

With hemodialysis you are more at risk for getting sick it important to follow these helpful tips-

- 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

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Staying active

Exercise can be a challenge when undergoing hemodialysis because you are tired a lot of the time but staying active can help you feel better. And especially if you had a very active lifestyle before continuing to stay active will help you feel better and stronger.

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.


Exercise Ideas-

Going for a walk around the house/ outside

Swimming

Yoga

Tai Chi

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!

To concluded here is a great video about living with Hemodialysis! You can find many more videos that can be supportive on Youtube.
Hemodialysis

Resources Used

"Dialysis Diet - Care Guide." Dialysis Diet - Care Guide. N.p., 2015. Web. 30 Nov. 2015.

http://www.drugs.com/cg/dialysis-diet.html


The Renal Diet. Little Rock: Hospital, 1973. The Renal Diet. VCU Health System, 2015. Web.

https://www.vcuhealth.org/transplant/docs/renal_diet.pdf


Pellico, Linda Honan. Focus on Adult Health: Medical-surgical Nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013. Print.