Question

d. Discuss these possible complications of hemodialysis for this patient and what assessments you would perform. with Infection/bleeding of access site and Disequilibrium syndrome

Answer 1

Haemodialysis
Complications can be :-
1. Hypotension ( low blood pressure ) - This is related to the speed and amount of fluid removed from your blood. Giving you some intravenous fluids can easily reverse this. Symptoms can vary. Tell the nurse if you experience dizziness, nausea, cramps in legs or any ‘funny feeling’. The best way to prevent this is for you to stick to the fluid restrictions that are set for you so that you avoid gaining too much fluid/weight between dialysis sessions.
2. Fluid overload- Between sessions, patients can some times develop a condition called fluid overload. This is due to excess fluid building up in your body. Fluid overload can be mild and manifest itself as swollen ankles, or high blood pressure, or severe breathlessness.
Constantly becoming fluid overloaded is not good , as it causes the blood pressure to rise and eventually damage the heart. If you think you are overloaded, contact the dialysis unit to organise extra dialysis to remove the fluid. If you are breathless or unwell, do not delay in contacting the dialysis unit.
3. Hyperkalemia - This means that there is too much potassium in the blood. This can be dangerous and life-threatening. High potassium can affect the muscles of the body including the heart, which could stop beating. By sticking to the diet, that the dietician has prescribed for you, you can avoid this serious complication.

Assessments for bleeding and infection from access site.
After dialysis, the needles will be removed from your fistula or graft. Your nurse will take every care to ensure that bleeding has stopped before you leave the unit.
If you should develop further bleeding, from your access site, apply a dry dressing to the site, apply gentle pressure to the area, and return to the unit immediately.

Assessment for disequilibrium syndrome
The treatment of disequilibrium after it has developed is aimed at reducing the intracranial pressure of the patient. Standard maneuvers are to give mannitol or hypertonic saline to raise the blood osmolality and to hyperventilate the patient