Вы находитесь на странице: 1из 25

Presented by: Renal Dialysis Unit

OBJECTIVES:
 Define TPE
Differentiate TPE from Hemodialysis and CRRT.
Identify indications and complication of TPE.
To outline essential components of nursing care for
patient’s receiving TPE.
INDICATION
CRRT TPE
(Continuous Renal (Therapeutic Plasma
Replacement Therapy) Exchange)

 A procedure in which the patient’s


 Any extracorporeal blood plasma is separated from whole blood.
purification therapy intended The removed plasma is replaced on a
1:1 ratio by a replacement solution
to substitute for impaired  Procedure can take 3-4 hrs. & the
renal function over an number of treatments needed is
dependent on the patients condition
extended period of time and & underlying disease
applied for or aimed at being  Autoimmune
applied for 24 hours/day.  Hematologic
 Neurologic
 Renal
 Transplantation
 Overdosing/Poisoning
Site/access
CRRT TPE
Hemodialysis (Continuous (Therapeutic
Renal Plasma
Replacement Exchange)
Therapy)

Site/Access

Fistula √ √ √

Synthetic Graft √ √ √

Temporary Catheter √ √ √

Permanent Catheter √ √ √
Catheters Arteriovenous (AV) Fistula
Synthetic Graft
Nursing
RESPONSIBILITIES
Pre- Procedure:
 Review Physicians order
 Obtain informed consent
 Laboratory investigations
 Intact vascular access
 Gather all equipment needed
 Physical examination
 Obtain baseline vital signs
Intra-Procedure
 Administer medications as per doctor’s order and
protocol.
 Monitor the following throughout the treatment:
● Hemodynamic, Neurologic and respiratory
status
● Input and Output
● Machine parameters
Post-Procedure
 Document any pertinent information/observations
such as patient general condition, response and any
complications noted
 Patient Education
Nursing RED
ALERTS!!!
No IV insertion & Blood
Extraction on AVF/AVG site
No BP monitoring on AVF/AVG
site
Hold antihypertensive
medications
Hold drugs that can be dialyzed
COMPLICATION
Hemodialysis/CRRT TPE
(Continuous Renal (Therapeutic Plasma
Replacement Therapy) Exchange)

 Hypotension  Citrate-Induced
 Bleeding Hypocalcemia
 Disequilibrium Syndrome  Coagulation Abnormalities
 Infection  Infection
 Air Embolism  Anaphylaxis
 Acute Hemolysis  Electrolyte Abnormalities
 Electrolyte Imbalances  Hypotension
 Pyrogen Reaction
 Development of Aneursym
HEALTHFUL
TIPS UPON
PATIENT
DISCHARGE
Education
Standard Hygiene
Psychological support
Thank you!!!

Вам также может понравиться