A client with chronic renal failure has completed a hemodialysis treatment. The nurse would use which of the following standard indicators to evaluate the client’s status after dialysis?
A. Potassium level and weight.
B. BUN and creatinine levels.
C. VS and BUN.
D. VS and weight.
Correct Answer: D. VS and weight.
Following dialysis, the client’s vital signs are monitored to determine whether the client is remaining hemodynamically stable. Weight is measured and compared with the client’s predialysis weight to determine the effectiveness of fluid extraction.
Option A: Monitor serum electrolytes, blood urea nitrogen, creatinine, and hemoglobin and hematocrit levels before and after dialysis. Monitor fluid status. Monitor coagulation studies because heparin is used to prevent clotting during dialysis.
Option B: The blood urea concentration is artificially low immediately following high-efficiency dialysis. Post-dialysis urea rebound correlates with hemodialysis efficiency and is inversely correlated with dialysis treatment time. Post-dialysis urea rebound varies among patients but should remain relatively constant in a given patient with stable hemodynamic parameters.
Option C: Laboratory studies are done as per protocol but are not necessarily done after the hemodialysis treatment has ended. After dialysis, assess the vascular access for any bleeding or hemorrhage. When you move the patient or help with ambulation, avoid trauma to or excessive pressure on the affected arm.
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