Hemodialysis Complications/ Renal Transplant

Question 1

What actions should the nurse perform prior to dialysis?

Answer 1

1. hold medications until after treatment

2. assess AV fistula for thrill/bruit

Question 2

What is continuous renal replacement therapy?

Answer 2

continuous renal replacement therapy is where blood filtering function of kidneys is continuously being circulated and mimics normal kidney function

Question 3

Where is CRRT done at?

Answer 3

only done at the ICU

Question 4

What type of patients receive a CRRT?

Answer 4

CRRT is only given to patients who are not stable enough for dialysis

Question 5

What should the nurse do to prevent clotting during dialysis?

Answer 5

clotting at access site is prevent by giving anticoagulants prior to dialysis and have the antidote available which is protamine sulfate

Question 6

What is disequilibrium syndrome?

Answer 6

too rapid a decrease in BUN/circulating fluid volume –> cerebral edema and increased intracranial pressure

Question 7

When does disequilibrium syndrome occur?

Answer 7

usually occurs after dialysis is complete

Question 8

What are clinical manifestations of disequilibrium syndrome?

Answer 8

change in LOC, seizures, and coma–>death

Question 9

What is the priority action to prevent disequilibrium syndrome from occurring?

Answer 9

use a slow rate exchange which will slow down dialysis and administer anticonvulsants if needed

Question 10

how can a nurse help treat hypotension in a dialysis patient?

Answer 10

1. slow the exchange rate
2. lower HOB
3. stop treatment if there is no improvement

Question 11

What are patient teaching points for AV access?

Answer 11

1. avoid compression of the site so cannot take BP or insert IVs
2. can take up to 4-6 weeks to mature
3. contact physician if bleeding lasts for > 30 minutes
4. no lifting heavy objects
5. do not sleep on top of extremity

Question 12

What candidates are eligible for a renal transplant?

Answer 12

1. anuria
2. proteinuria
3. azotemia (elevated BUN/creatinine)
4. fluid volume excess conditions like HF and pulmonary edema
5. GFR <20

Question 13

What candidates are not available for renal transplants?

Answer 13

1. age >70 years for <2 years of ag e
2. cancer
3. addiction

Question 14

What should the patient monitor for after a renal transplant?

Answer 14

monitor for signs of infection, rejection, fluid and electrolyte imbalances
rejection= signs of kidney failure

Question 15

What medications need to be taken after a kidney transplant?

Answer 15

1. immunosuppressants need to be taken for life and start before the transplant if possible
2. diuretics
3. steroids to prevent inflammation and rejection

Question 16

What type of diet should a renal transplant patient follow?

Answer 16

1. Low-fat
2. High-fiber
3. Increased protein
4. adequate intake of potassium, phosphorus, and calcium
5. restrict sodium intake to prevent fluid retention

Question 17

What are nursing education points to give to a kidney transplant patient?

Answer 17

1. avoid contact sports/trauma

2. Avoid crowds or wear mask

Question 18

when can rejection of the kidney transplant occur?

Answer 18

rejection can occur immediately (within 48 hours) or after years

Question 19

What is the treatment for a hyperacute kidney transplant rejection?

Answer 19

treatment for hyperacute rejection of kidney transplant includes removing of the donor kidney

Question 20

What is the treatment for an acute kidney transplant rejection?

Answer 20

treatment for acute rejection of kidney transplant would be to increase immunosuppressants

Question 21

What is the treatment for a chronic rejection of a kidney transplant?

Answer 21

treatment if chronic rejection includes conservative care, and then dialysis