Dialysis Complications and Emergency Management Flashcards

What is the most common cause of intradialytic hypotension?

Answer: Ultrafiltration rate exceeding plasma refilling rate

Intradialytic hypotension most commonly occurs when the ultrafiltration rate exceeds the body's ability to refill the intravascular space from interstitial fluid.

Which electrolyte imbalance is most likely to cause life-threatening cardiac arrhythmias in a dialysis patient?

Answer: Hyperkalemia

Hyperkalemia is the most immediately life-threatening electrolyte abnormality in dialysis patients, capable of causing fatal ventricular arrhythmias.

A patient develops fever and shaking chills approximately 45 minutes into hemodialysis. What is the most likely cause?

Answer: Pyrogenic reaction from contaminated dialysate or equipment

Pyrogenic reactions are caused by bacterial endotoxins in dialysate or equipment, triggering an immune response with fever and rigors.

When treating intradialytic hypotension, which intervention should be performed first?

Answer: Place patient in Trendelenburg position and reduce ultrafiltration

Placing the patient flat or in Trendelenburg and reducing or stopping ultrafiltration is the immediate first response to intradialytic hypotension.

Which dialysis complication is specifically associated with inadequate bicarbonate delivery in the dialysate?

Answer: Metabolic acidosis

Inadequate bicarbonate in dialysate fails to correct the chronic metabolic acidosis that accumulates between hemodialysis sessions.

A patient reports painful leg and foot cramps during the last hour of hemodialysis. What is the most appropriate initial intervention?

Answer: Reduce blood flow rate and administer hypertonic saline or glucose

Dialysis-related muscle cramps are treated by reducing ultrafiltration rate and administering hypertonic saline or glucose to rapidly expand intravascular volume.