CCHT Interventions 2

Question 1

A patient develops hypotension (BP 80/50) during dialysis with associated diaphoresis and pallor. After stopping ultrafiltration, what is the next immediate intervention?

Accepted Answer

Place patient in Trendelenburg position and administer a normal saline bolus

Answer

Administer 25% albumin solution

Answer

Increase blood pump speed to improve cardiac output

Answer

Administer antihypertensive medications to stabilize BP

Question 2

What is the first-line intervention for a patient experiencing first-use syndrome during hemodialysis?

Accepted Answer

Stop dialysis, clamp and discard blood lines, administer antihistamine and notify physician

Answer

Continue treatment as the reaction is mild and self-limiting

Answer

Switch to a different dialyzer type without stopping treatment

Answer

Increase ultrafiltration to remove the offending substances

Question 3

During hemodialysis, a patient develops sudden severe chest pain, dyspnea, and becomes cyanotic. The blood in the venous line appears pink/clear instead of dark red. What emergency is occurring?

Accepted Answer

Hemolysis (red cell destruction from mechanical or chemical causes)

Answer

Pulmonary embolism from DVT

Answer

Severe hypotension causing tissue hypoperfusion

Answer

Air embolism from a disconnected blood line

Question 4

What is the appropriate response when a dialysis patient develops seizures during treatment?

Accepted Answer

Protect the patient from injury, stop UF, reduce blood pump speed, notify nurse/physician, and prepare to terminate treatment

Answer

Restrain the patient to prevent injury and continue treatment

Answer

Administer IV diazepam immediately without notifying the physician

Answer

Increase blood pump speed to improve cerebral perfusion

Question 5

A patient on hemodialysis suddenly develops fever of 39.5 degrees C and shaking chills during treatment. What is the most likely cause and appropriate action?

Accepted Answer

Pyrogen reaction or bacteremia; stop treatment, take blood cultures, notify physician, administer antipyretics as ordered

Answer

Dialysate temperature too high; reduce dialysate temperature and continue

Answer

Normal response to fluid removal; apply cool compresses and continue

Answer

Allergic reaction to heparin; stop heparin infusion and continue treatment

Question 6

What is the correct initial management of a suspected air embolism during hemodialysis?

Accepted Answer

Clamp the venous line, place patient in left lateral decubitus Trendelenburg position, stop blood pump, call for help

Answer

Increase blood pump speed to push air through the heart quickly

Answer

Place patient upright to allow air to rise and exit the pulmonary circulation

Answer

Continue treatment and monitor as small amounts of air are not clinically significant