CDN Complications and Emergency Management

Question 1

What is the most common acute complication during hemodialysis?

Accepted Answer

Hypotension

Answer

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.

Question 2

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

Accepted Answer

Acute pulmonary edema

Answer

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.

Question 3

What is the immediate treatment for intradialytic hypotension?

Accepted Answer

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

Answer

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.

Question 4

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

Accepted Answer

Hyperkalemia

Answer

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

Question 5

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

Accepted Answer

New patient receiving first aggressive hemodialysis treatment with high BUN

Answer

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.

CDN - Certified Dialysis Nurse Practice Test

CDN - Certified Dialysis Nurse Practice Test

CDN Complications and Emergency Management