Dialysis Adequacy and Prescription Flashcards

Which dialysate potassium concentration is most appropriate for a patient with a pre-dialysis serum potassium of 6.5 mEq/L?

Answer: 2 mEq/L

A 2 mEq/L potassium dialysate bath creates a favorable gradient for potassium removal in significantly hyperkalemic patients while reducing cardiac arrhythmia risk.

What is the primary purpose of sodium profiling during hemodialysis?

Answer: Improve cardiovascular stability and reduce intradialytic hypotension

Sodium profiling uses higher sodium concentrations early in treatment to maintain plasma osmolality and improve hemodynamic stability, reducing intradialytic hypotension.

A patient on hemodialysis has a target dry weight of 72 kg and arrives weighing 75.5 kg. What is the interdialytic weight gain, and is it within recommended limits?

Answer: 3.5 kg — exceeds the recommended 2–3 kg limit

The interdialytic weight gain is 3.5 kg (75.5 − 72 = 3.5), which exceeds the generally recommended limit of 2–3 kg between sessions.

What is the maximum recommended ultrafiltration rate to minimize cardiovascular stress during hemodialysis?

Answer: 13 mL/kg/hour

Ultrafiltration rates exceeding 13 mL/kg/hour are associated with increased cardiovascular stress, myocardial stunning, and higher mortality risk.

Which dialysate bicarbonate concentration is typically used for hemodialysis patients with metabolic acidosis?

Answer: 35–38 mEq/L

A dialysate bicarbonate of 35–38 mEq/L provides a diffusion gradient to correct metabolic acidosis common in end-stage renal disease patients.

What blood flow rate and dialysate flow rate combination best optimizes small solute clearance during standard hemodialysis?

Answer: Qb 300 mL/min / Qd 500 mL/min

A blood flow of 300 mL/min with a dialysate flow of 500 mL/min is the standard prescription that balances solute clearance efficiency with patient tolerance.