Problem
Blood pressure reading of 90/60 mm hg or below.
What is Hypotension?
Rapid decrease in fluid volume, antihypertensive medications, narcotics, anemia and dehydration.
What are causes of hypotension?
Chest pain, shortness of breath, cyanosis or seizures.
Monitor vital signs closely, obtain order for cool dialysate, monitor blood volume and UF profile.
What are preventative measures for Hypotension?
Normal saline bolus, minimum UFR/decrease UF goal, administer O2 if ordered and osmotic agents as ordered.
What is the treatment for Hypotension?
Large amount of air enters the patients veins or arteries.
What is Air Embolism?
Bloodline disconnection or malfunctioning air detect sensor.
What are causes an air embolism?
"Cherry soda pop" color, burning sensation in the access extremity, usually the venous needle, abdominal pain or cramping, low back pain, N/V, chest pain, SOB or indigestion.
What are the signs and symptoms of hemolysis
Short dialysis times, (2 hours), low blood flow (200-250 ml/min), low dialysate flow 4-500 ml/min), small surface area dialyzer
What are preventative measures for Disequilibrium Syndrome?
Clamp the blood lines and stop dialysis.
What is the treatment for an air embolism?
Rupture of red blood cells, causing intracellular potassium to be released.
What is hemolysis?
Immune response to foreign substance, hypersensitivity to ethylene oxide, or hypersensitivity to dialyzer.
What are causes of dialyzer reaction?
Sudden or gradual decrease in blood pressure, dizziness, lightheadedness, nausea, perspiration, cold clammy skin and tachycardia.
What are signs and symptoms of Hypotension.
Ensure access connections are secure, needles are taped securely, and all test are passed before initiating treatment.
What are preventative measures for air embolism?
Notify physician, stop the dialysis if symptoms warrant, DO NOT RETURN BLOOD, administer O2, call rapid response if warranted, treat symptoms.
What are treatment measures for a dialyzer reaction?
New patients are at the highest risk of developing this complication?
What is disequilibrium syndrome?
Exposure of blood to chemicals, overheated dialysate, kinking of blood lines, overoccluded blood pumps or poorly positioned needle.
What are causes of hemolysis
Headache, nausea, dizziness, muscle cramping, blurred vision, tremors, agitation/restlessness, hypertension, seizure, coma, sudden cardiac arrest.
What are signs and symptoms of Disequilibrium Syndrome?
Ensure the machine is disinfectant free before connecting Hanson or dialyzer coupling, verify correct dialysate order, verify dialysate temperature.
What are preventative measures for hemolysis?
Clamp blood lines immediately, stop the blood pump, and treat the patients symptoms, blood sample taken from dialysate for ph and conductivity and a blood sample should be taken from the patient to check for hematocrit, electrolytes, free hemoglobin and haptoglobin.
What is the treatment for hemolysis?
Referred to as "first use syndrome".
What is dialyzer reaction?
Aggressive urea removal during initial HD treatment, may occur when predialysis BUN is > 150mg/dl
What are causes of Disequilibrium Syndrome?
Itching, nausea, generalized achiness, hives, back pain, chest pain, acute bronchospasm or wheezing, hypotension, anaphylactic reaction.
What are signs and symptoms of a dialyzer reaction?
Prime the dialyzer at the manufacturer's suggested rate and volume, complete full recirculation cycle, refresh the prime immediately prior to starting treatment, review patient records.
What are preventative measures for a dialyzer reaction?
Notify physician, treat symptoms, administer medications as ordered (osmotic medications/mannitol)
What are treatments for Disequilibrium Syndrome?