A female client with acute renal failure is undergoing dialysis for the first time. The nurse in charge monitors the client closely for dialysis equilibrium syndrome, a complication that is most common during the first few dialysis sessions. Typically, dialysis equilibrium syndrome causes:
A. Confusion, headache, and seizures.
B. Acute bone pain and confusion.
C. Weakness, tingling, and cardiac arrhythmias.
D. Hypotension, tachycardia, and tachypnea.
Correct Answer: A. Confusion, headache, and seizures.
Dialysis equilibrium syndrome causes confusion, a decreasing level of consciousness, headache, and seizures. These findings, which may last several days, probably result from a relative excess of interstitial or intracellular solutes caused by rapid solute removal from the blood. The resultant organ swelling interferes with normal physiologic functions. To prevent this syndrome, many dialysis centers keep first-time sessions short and use a reduced blood flow rate.
Option B: Acute bone pain and confusion are associated with aluminum intoxication, another potential complication of dialysis. Aluminum intoxication occurs in patients on chronic dialysis because of the accumulation of aluminum in the body, especially bone, due to aluminum present in dialysis fluids and/or aluminum-containing antacids. Disease manifestations can include acute dementia and a peculiar form of unresponsive severe osteomalacia.
Option C: Weakness, tingling, and cardiac arrhythmias suggest hyperkalemia, which is associated with renal failure. Hyperkalemia is a frequent finding in patients with chronic kidney disease (CKD). This increase in serum potassium levels is associated with decreased renal ion excretion, as well as the use of medications to reduce the progression of CKD or to control associated diseases such as diabetes mellitus and heart failure.
Option D: Hypotension, tachycardia, and tachypnea signal hemorrhage, another dialysis complication. Hemodialysis (HD) patients are generally believed to have an elevated bleeding risk. Bleeding in uremia relates to an acquired defect of primary hemostasis caused by platelet dysfunction and altered platelet–vessel wall interaction.
No comments:
Post a Comment