A female client with chronic renal failure (CRF) is receiving a hemodialysis treatment. After hemodialysis, nurse Sarah knows that the client is most likely to experience:
A. Hematuria.
B. Weight loss.
C. Increased urine output.
D. Increased blood pressure.
Correct Answer: B. Weight loss.
Because CRF causes loss of renal function, the client with this disorder retains fluid. Hemodialysis removes this fluid, causing weight loss. The client’s normal weight without any extra fluid in the body is called “dry weight.” Extra fluid can be dangerous and cause extra strain on the body, including the heart and lungs. When the client has kidney failure, her body depends on dialysis to get rid of the extra fluid and wastes that build up in her body between treatments.
Option A: Hematuria is unlikely to follow hemodialysis because the client with CRF usually forms little or no urine. Hematuria in hemodialysis patients may be a manifestation of the bleeding diathesis seen in renal failure. But it certainly needs further evaluation for structural causes specific to the genitourinary tract and to prevent massive bleeding.
Option C: Hemodialysis doesn’t increase urine output because it doesn’t correct the loss of kidney function, which severely decreases urine production in this disorder. Dialysis, a procedure that uses a special machine to replace the kidneys in filtering waste from the bloodstream, may reduce the daily urine output that a person normally produces. This happens because as the blood is filtered during dialysis, fluid is removed, thus reducing the kidneys’ traditional role.
Option D: By removing fluids, hemodialysis decreases rather than increases the blood pressure. The most common side effect of hemodialysis is low blood pressure. It can occur when too much fluid is removed from the blood during hemodialysis. This causes pressure to drop, and nausea and dizziness can result.
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