I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: Home Dialysis => Topic started by: MOMMADUKES on February 10, 2011, 05:27:47 PM
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Hi Guys!
I am an old dialysis nurse, well experienced I don't think I'm that old. I was just trained to teach patients PD. I finished training my first patient last week. We had 6 training sessions and I think we both did really well. Now he's home and having trouble draining. I had him sit in different positions, lie flat and stand up. After 20 minutes only 1200 out after 2000 ml in on a 1.5% solution. Any ideas. Catheter is in place, went for X-Ray yesterday. No Fibrin in bag or lines. I'm not sure of what to do next, thinking maybe putting him on a 2.5% soln., but he is still urinating don't want to cramp him up.????? At a loss any suggestions would be appreciated.
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Fibrin can get caught inside the cavity where the tube sucks the liquid up. If it is clogging you may not see it in the lines or bag. Could be a big ball of it inside him. Try some heprin cant hurt. Also the results of his XRAY?? My tube turned itself up (northwords) once and i couldnt drain.
He needs a KT/V he may be absorbing much of the liquid. He also may have a lower hernia and the liquid would drain into his neather regions. Is he swollen down there?
Last but not least it could be the machine. Good luck to you both.
P&K
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Hi Guys!
I am an old dialysis nurse, well experienced I don't think I'm that old. I was just trained to teach patients PD. I finished training my first patient last week. We had 6 training sessions and I think we both did really well. Now he's home and having trouble draining. I had him sit in different positions, lie flat and stand up. After 20 minutes only 1200 out after 2000 ml in on a 1.5% solution. Any ideas. Catheter is in place, went for X-Ray yesterday. No Fibrin in bag or lines. I'm not sure of what to do next, thinking maybe putting him on a 2.5% soln., but he is still urinating don't want to cramp him up.????? At a loss any suggestions would be appreciated.
It sounds as if the patient is doing CAPD with a few exchanges per day with mainly 1.5% If so, how long are they letting go between each treatment? If they are letting the fluid dwell longer than 4 or 5 hours, then the body will re absorb some of the fluid. I would try a 2.5%. Also, if he is still uriniating, are you including the amount he is putting out? Perhaps have him measure his fluids for a day and calculate that into the equation to see if that is where the extra fluid is going...
///M3R
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Constipation ! Thats very common and can have this effect :2thumbsup;
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Thank you all sooo much!! I was so happy to log on and find people actually answered me. After I posted I thought maybe I was invading space I shouldn't have. Saw my patient today and ended up sending him back to the surgeon for laproscopic intervention. Hopefully All will be well. Thank you all again!! God Bless.
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Constipation ! Thats very common and can have this effect :2thumbsup;
FYI.....pooping twice a day still doesn't mean you aren't constipated. I refused to believe that my problem alarms and drain issues were bowel related. I started taking stool softeners and problem solved. I also have a hernia and I lose fluid to that also.
I think you are more then welcome here. People like to help others help patients. Coming here will make you a better PD nurse.
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I'm a wickedly fast transporter and I have absorbed 700ml in three hours. It got old quick, too.
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I had the same issue. They thought fibrin and gave me heparin, didn't work... sent me home with "Go Lightly"- basically, colon-blow for when someone needs a colonscopy- NOT THE PROBLEM! :banghead; Went to a surgeon, and there was some fatty tissue hanging down, clamping off the cath. The surgeon tacked it up, and I haven't had a problem since... a lot of caths. have this problem, for some reason. Surgery sucks, but it does help.
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I am just wondering how long is he dwelling for? maybe he just absorbs quickly, if so maybe add more exchanges during the day and see if that makes a difference... good luck :)