Case Presentation

NURSING CARE PLAN
PERITONEAL
DIALYSIS
Presented by: KIANA OCFEMIA- BSN 3

WHAT IS PERITONEAL DIALYSIS?
 Peritoneal Dialysis accomplishes the removal of waste and excess
fluid by using the abdominal lining, called the peritoneal
membrane, as a filter a membrane across which fluids dissolved
substances (electrolytes, urea, glucose, albumin and other small
particles) are exchanged from the blood.
 Peritoneal Dialysis is similar in principle to hemodialysis. Both of
these forms of renal replacement therapy depend upon the
passive movement of water dissolved substances across a
semipermeable membrane. This process called diffusion.
 Peritoneal dialysis is sometimes prefer because it uses a simpler
technique and provides more gradual physiological changes than
hemodialysis.
 The manual single-bag method is usually done as an inpatient
procedure with short dwell times of only 30-60 minutes and is
repeated until desired effects are achieved. The most commonly
used type of peritoneal dialysis is continuous ambulatory
peritoneal dialysis (CAPD), which permits the patient to manage
the procedure at home with bag and gravity flow, using a
prolonged dwell time at night and a total of 3-5 cycles daily, 7
days a week. NO MACHINERY IS REUIRED.
 Continuous cycling peritoneal dialysis (CCPD) mechanically
shorter dwell times during night (3-6 cycles) with one 8 hrs. dwell
time during daylight hrs. increasing the patient’s independence.
An automated machine is required to infuse and drain dialysate
at preset interval.
ADVANTAGES AND
DISADVANTAGES OF
PERITONEAL DIALYSIS
ADVATANGES:
-HOME-BASED TREATMENT
-LESS RETRICTIVE DIET
-FEWER HOSPITAL VISITS
DISADVANTAGES:
-POTENTIAL FOR INFECTION
-FLUID RESTRICTIONS
-CATHETER DISCOMFORT
WH0 IS PERIT0NEAL DIALYSIS
SUITABLE F0R?
 PEOPLE WITH KIDNEY FAILURE WHO ARE UNABLE TO UNDERGO
HEMODIALYSIS.
 PEOPLE WHO PREFER A MORE HOME-BASED TREATMENT OPTION.
 PEOPLE WHO ARE RELATIVELY HEALTHY AND ABLE TO MANAGE
THEIR OWN TREATMENT.
NURSING CARE PLAN AND
MANAGEMENT
 The nursing care plan goal for patients undergoing peritoneal
dialysis include maintaining fluid and electrolyte balance,
monitoring vital signs and weight changes, assessing for signs of
infection, and ensuring proper placement and functioning of the
catheter.
 Another important goal is educate the patient on the self-care
techniques needed for peritoneal dialysis and to provide
emotional support throughout the treatment process.
PATIENT PROFILE
 AGE: 65 years old.

 GENDER: Male
 DIAGNOSIS: End-stage renal disease (ESRD)
 PROCEDURE: Peritoneal Dialysis (PD)
 COMORBIDITIES: Hypertension, type 2 diabetes
mellitus
NURSING ASSESSMENT
SUBJECTIVE DATA
 Patients report fatigue, shortness of breathe and abdominal discomfort
 Expresses the anxiety about the effectiveness about the dialysis and potential
complications
OBJECTIVE DATA
vital signs
BP: 160/90mmHg
HR: 80bpm
TEMP. 36.9’c
WEIGHT: Increased by 4kg since the last session.
LAB RESULTS: Elevated creatinine(6.0mg/dL) hyperkalemia (5.5mEq/L)
ABDOMINAL ASSESSMENT: Mild distension and tenderness: no signs of infection
NURSING DIAGNOSIS
 Excess fluid volume related to renal failure and inadequate
dialysis.
 Risk for infection related to catheter placement and potential
peritonitis.
 Imbalanced Nutrition: less than body requirements related to
dietary restrictions and dialysis-related protein loss.
 Anxiety related to health status and understanding of the dialysis
process.
 Knowledge Deficit: related to self-care management of peritoneal
dialysis.
NURSING GOALS/OUTCOMES
 The patient will maintain a weight within 1kg of the target weight
and exhibit no signs of fluid overload.
 The patient will demonstrate proper catheter care techniques.
Showing no signs of infection.
 The patient will consume a balanced diet as advised by a
dietitian and report increased energy level.
 The patient express reduced anxiety and demonstrate coping
strategies by the next appointment.
 The patient will articulate understanding of peritoneal dialysis
procedures and self-care by the end of the education session.
IMPLEMENTATION
 Conduct daily weight measurements and assess vital signs.
 Measure and document Intake and Output.
 Observe for signs of fluid overload such as edema and
hypertension.
 Implement strict hand hygiene protocols before catheter handling.
 Educate the patient and family on catheter care, emphasizing site
cleanliness and monitoring for signs of infection.
 Schedule routine assessments of the catheter site of redness,
swelling or discharge.
 Collaborate to a dietitian to create a personalized meal plan that
meets dietary restrictions(sodium, potassium)
 Educate the patient on the importance of the protein intake to
compensate for losses during dialysis.
 Encourage frequent, small meal to help improve energy levels.
 Provide a supportive environment where the patient can express
concerns and fears.
 Introduced relaxation techniques, such as deep breathing
exercises and guided imagery.
 Develop and provide education materials about peritoneal
dialysis including a step-by-step guide for self-care.
NURSING EVALUATION
 Monitor and document the patient’s weight and vital signs to
confirm fluid management effectiveness.
 Assess the catheter site at each visit for signs of infection.
 Ensure the site remains clean and dry.
 Evaluate dietary compliance through food diaries and the
patient’s reported energy levels.
 Check in the patient’s anxiety level using standardized tools or
patient self-reporting.
 Confirm understanding of peritoneal dialysis process to verbal
quizzes or demonstrations by the patients.
DO YOU HAVE ANY
QUESTIONS?
SIGE SUBUKAN MO MAG
TANONG:

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NURSING CARE PLAN

Presented by: KIANA OCFEMIA- BSN 3

 AGE: 65 years old.

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