Complications and Emergency Management Flashcards

What is the most common acute complication during hemodialysis?

Answer: Hypotension

Intradialytic hypotension (IDH) is the most common acute complication of hemodialysis, occurring in approximately 20–30% of treatments due to rapid fluid removal and autonomic dysfunction.

A dialysis patient suddenly develops chest pain, dyspnea, cyanosis, and frothy pink sputum during treatment. What complication should be suspected?

Answer: Acute pulmonary edema

Frothy pink sputum, dyspnea, and cyanosis during dialysis indicate acute pulmonary edema, which may occur if ultrafiltration is insufficient or if the patient develops a cardiac event.

What is the immediate treatment for intradialytic hypotension?

Answer: Place the patient in Trendelenburg position, reduce or stop ultrafiltration, and give a normal saline bolus

Immediate management of IDH includes Trendelenburg positioning, stopping or reducing ultrafiltration, and administering a normal saline bolus of 100–250 mL to restore intravascular volume.

Which electrolyte abnormality is the most common cause of cardiac arrest in hemodialysis patients between treatments?

Answer: Hyperkalemia

Hyperkalemia is the leading electrolyte cause of between-treatment cardiac arrest in hemodialysis patients, as potassium accumulates rapidly without renal excretion.

Dialysis disequilibrium syndrome (DDS) is most likely to occur in which clinical scenario?

Answer: New patient receiving first aggressive hemodialysis treatment with high BUN

DDS occurs when rapid urea removal creates an osmotic gradient that draws water into brain cells, most commonly in new patients with very high BUN receiving their first aggressive dialysis.

What is the emergency treatment for suspected air embolism during hemodialysis?

Answer: Immediately clamp venous line, stop blood pump, place patient in left lateral Trendelenburg position, and call for emergency help

Air embolism requires immediate cessation of blood flow, left lateral Trendelenburg positioning (to trap air in right ventricle away from pulmonary circulation), and emergency medical support.