Dialysis Complications and Emergency Management Flashcards

A patient on hemodialysis suddenly develops nausea, headache, and altered consciousness near the end of treatment. What condition should the nurse suspect?

Answer: Dialysis disequilibrium syndrome

Dialysis disequilibrium syndrome (DDS) occurs due to rapid solute removal causing osmotic cerebral edema, typically in new or high-BUN patients.

What is the first action when an air embolism is suspected during hemodialysis?

Answer: Administer 100% oxygen and clamp the venous line

Clamping the venous blood line immediately stops air from entering the patient while 100% oxygen helps reabsorb nitrogen bubbles.

A patient develops pink-tinged blood in the dialysate port during hemodialysis. What does this most likely indicate?

Answer: Dialyzer membrane leak

Pink or red-tinged dialysate indicates a dialyzer membrane rupture, which can allow blood to leak into the dialysate compartment.

Intradialytic hypotension is most effectively prevented by which of the following interventions?

Answer: Limiting the ultrafiltration rate to ≤13 mL/kg/hour

Limiting ultrafiltration to ≤13 mL/kg/hour reduces the rate of fluid removal, allowing adequate plasma refilling and preventing hemodynamic instability.

Which set of symptoms is most consistent with a Type A hypersensitivity reaction to the dialyzer?

Answer: Burning, flushing, dyspnea, and anaphylaxis in the first few minutes

Type A (anaphylactic) reactions occur within the first few minutes of dialysis due to IgE-mediated sensitivity to ETO sterilization or membrane components.

A patient receiving hemodialysis develops severe chest pain and dyspnea. The nurse suspects hemolysis. What is the characteristic appearance of the blood in the extracorporeal circuit?

Answer: Cherry-red, translucent blood

Hemolysis causes red blood cells to rupture and release hemoglobin, making the blood appear cherry-red and translucent rather than opaque.