Thank you that was very simple, clear and concise! I am a RN student graduating next month and this video refreshed my understanding of the rule of 7 for my summary paper I'm doing. Thanks again and be blessed!
In hospital, allot of my Drs tended to ignore all the rules of thumb. 1k all day. No I didn't like it. Yes I've seen legit disequilibrium and yes I've had to tell a doctor "this pts treatment is over period call my manager of you want, I'm not doing it." Their favorite thing to ignore is the 13ml/kg/hr limit. Never forget when they ordered a2liter removal on a first time, 2hr tx. I did verify and yep, do it he said. Pt went blind. Dumped 2 shots of 200ml back he recovered his sight and he got the full two hours luckily. I've also had the opposite where the pt did just fine. Rules of thumb are GREAT. But. Everybody's different. You never really know what will happen in a treatment. Great video!
I’m a new nurse in a chronic setting and I’m feeling overwhelmed with how many patients my clinic has. A total of over 100 or so patients. I’m not sure how I’m supposed to learn everything about all of them.
That is overwhelming! You don’t have to learn everything about them, like their whole history. Focus on their dialysis, fluid gains, access, any intradialytic symptoms and infection prevention. You don’t need to know their whole history like u did In clinicals. The patients will tell u most things u need to know about them :)
Hey Lindsey! This is interesting. I work in an incenter dialysis unit (in Canada) where we see 'chronic' hd pts but they are still considered unstable to go to the community hd units (clinics in the US). We have a K protocol we follow after we do their bloodwork which is q6 weeks. We have a lot of pts that are on 1 or 1.5k baths!
@@dialysisnurselindsey yes! We also have our own iron protocol. We do iron BW q3mos, and depending on the results we follow the iron protocol and change their iron dosing/frequency! Our incenter has a total of 46 beds/chairs (42 max pts/run). We start of our morning runs with 3pts/1nurse. We do all the cannulation/CVCs, meds and assessments. Our techs only set up/prime the machines but we do everything else including rx inputs. We use fresenius and we also have pts on HDF!
Do you happen to know of how a similar rule may be applied to the Nxstage Pureflow and hanging bag dialysate that is used for home hemodialysis? My Mom has had a potassium of 2.7 with her 25 liter 307 Pureflow SAK after HHD before and had to reschedule cataract surgery because of it but that is the only time we've had the opportunity to have a post dialysis potassium.
(My Mom is 75 years old with diabetes, COPD, and bronchiectasis. Her primary physician put her on a potassium supplement but I don't know if that is how it should be managed?)
A post potassium drawn within 2-3 hours post dialysis is going to be skewed, and not accurate, and falsely low. The most accurate post potassium blood draw is done 3 hours after dialysis. I think the cataract peeps need to be educated on this. Thank u for ur question!!
How do you know what their potassium level is if you are doing home dialysis? Do you need to look at the monthly blood work to decide this? Doesn't things like Blood Pressure, pulse and weight gain usually decide what bath to give them?
Hi mam lindsey.. im a dialysis nurse.. can you teach us the proper blood vessel where to exactly cannulate it especially during avf initiation. We are not very confident if we are hitting the right vessel and we are concern if we are recirculating blood.. thank you!
ua-cam.com/video/syeW621uOgA/v-deo.html This video will help u! Make sure ur needles are 2 inches apart! I get lots of questions on needle insertion so u are not alone! I’ll work on a video that focus’s on these questions! Thank u so much!
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Thank you that was very simple, clear and concise! I am a RN student graduating next month and this video refreshed my understanding of the rule of 7 for my summary paper I'm doing. Thanks again and be blessed!
Omg I love this, you made my day. Thank u!
@@dialysisnurselindseydear still i am very confused accoridng to potassium calculation
In hospital, allot of my Drs tended to ignore all the rules of thumb. 1k all day. No I didn't like it. Yes I've seen legit disequilibrium and yes I've had to tell a doctor "this pts treatment is over period call my manager of you want, I'm not doing it." Their favorite thing to ignore is the 13ml/kg/hr limit. Never forget when they ordered a2liter removal on a first time, 2hr tx. I did verify and yep, do it he said. Pt went blind. Dumped 2 shots of 200ml back he recovered his sight and he got the full two hours luckily. I've also had the opposite where the pt did just fine. Rules of thumb are GREAT. But. Everybody's different. You never really know what will happen in a treatment. Great video!
I hear u 💯. You could be my nurse anytime!
We use sliding scale orders for our inpatients which is nice.
Thank you for all your videos
Awww ur welcome!! 🥰
Hlo mam iam dialysis technician in india 👍🥰🥰👌👌👌...tq for video
Hi! Welcome to my channel!!! Any video requests?
Yes mam... explain the 3K bath for pre dialysis ... with example.mam pls 🥰
SUCH A HELPFUL VIDEO… So, what if the patient’s potassium is 2.9, how often should the k bath be given? Is 3 K too high?
Always defer to the providers orders. But 3 k is a very common potassium bath 🛁 😃
and thank u!!
I’m a new nurse in a chronic setting and I’m feeling overwhelmed with how many patients my clinic has. A total of over 100 or so patients. I’m not sure how I’m supposed to learn everything about all of them.
That is overwhelming! You don’t have to learn everything about them, like their whole history. Focus on their dialysis, fluid gains, access, any intradialytic symptoms and infection prevention. You don’t need to know their whole history like u did In clinicals. The patients will tell u most things u need to know about them :)
Thank you for your presentation
So what about crrt sessions if we had pt has k level 7 hyperkalemia so what type of Dialysate solution to use ?
Anyone have a sliding scale dialysate bath protocol at their clinic?
Hey Lindsey! This is interesting. I work in an incenter dialysis unit (in Canada) where we see 'chronic' hd pts but they are still considered unstable to go to the community hd units (clinics in the US). We have a K protocol we follow after we do their bloodwork which is q6 weeks. We have a lot of pts that are on 1 or 1.5k baths!
@@kyzlyperalta9724 I’m so jealous of ur K protocol!! What an interesting unit. I want to know more... How many people do u run at a time?!
@@dialysisnurselindsey yes! We also have our own iron protocol. We do iron BW q3mos, and depending on the results we follow the iron protocol and change their iron dosing/frequency! Our incenter has a total of 46 beds/chairs (42 max pts/run). We start of our morning runs with 3pts/1nurse. We do all the cannulation/CVCs, meds and assessments. Our techs only set up/prime the machines but we do everything else including rx inputs. We use fresenius and we also have pts on HDF!
wow, what a busy unit 🥼 And u get to do all the fun things like labs and cannulate and meds 🧪 👏🏻
I've had that. One doctor only. Other drs, 2k all day. Other doctor actually wrote his calculations in his order set LOL. Hospitals be crazy. 😁👍🏻
Do you happen to know of how a similar rule may be applied to the Nxstage Pureflow and hanging bag dialysate that is used for home hemodialysis? My Mom has had a potassium of 2.7 with her 25 liter 307 Pureflow SAK after HHD before and had to reschedule cataract surgery because of it but that is the only time we've had the opportunity to have a post dialysis potassium.
(My Mom is 75 years old with diabetes, COPD, and bronchiectasis. Her primary physician put her on a potassium supplement but I don't know if that is how it should be managed?)
A post potassium drawn within 2-3 hours post dialysis is going to be skewed, and not accurate, and falsely low. The most accurate post potassium blood draw is done 3 hours after dialysis. I think the cataract peeps need to be educated on this. Thank u for ur question!!
@@dialysisnurselindsey ohhh... this is excellent information to have and share! Thank-you!! 🦋
Very helpful.
Thank u!! 😃
How do you know what their potassium level is if you are doing home dialysis? Do you need to look at the monthly blood work to decide this? Doesn't things like Blood Pressure, pulse and weight gain usually decide what bath to give them?
When u say home dialysis, do u mean peritoneal dialysis or home hemodialysis?
Hi so if K is high and bath is changed to 1K is for the whole duration of tx or just for the forst hour of tx?ty
This is per provider order 😃 check with ur doctor. I see it happen both ways
Where do u located the K bath
How do you manually mix your 2k bath to make it 3k bath? For you incorporate potassium chloride to your bath?
Is this similar rule regarding calcium baths also?
i'm not sure, great question! thank you!
Hi! what if the doctors order is K negative bath? Thanks!
Like a 0 bath? The lowest K bath I’ve seen is a 1 k
Yes! pt K 8.7 and crea is 1500 with eGFR 3
If that why the provider wants! Sounds like the pt was very very sick. Lowest we go is 1k bath
Hi mam lindsey.. im a dialysis nurse.. can you teach us the proper blood vessel where to exactly cannulate it especially during avf initiation. We are not very confident if we are hitting the right vessel and we are concern if we are recirculating blood.. thank you!
ua-cam.com/video/syeW621uOgA/v-deo.html
This video will help u! Make sure ur needles are 2 inches apart! I get lots of questions on needle insertion so u are not alone! I’ll work on a video that focus’s on these questions! Thank u so much!
How to make K2 Or k4 bath if it is not available in readymade mode.
I mean how many Kcl ampules we have to add in 10 litre acid part so that we will use it as k3 Or k4 bath.
Definitely have to check ur facility policy for this question. Will very from clinic to clinic. And you have to be careful with potassium!
Our monitor has no K bath where u will findi it in monitor
What a potassium bath mean?
Bath is the “acid” that is mixed with bicarbonate and water to form Dialysate
@@dialysisnurselindsey oh ok . thanks