After the first hemodialysis treatment, your patient develops a headache, hypertension, restlessness, mental confusion, nausea, and vomiting. Which condition is indicated?
A. Disequilibrium syndrome
B. Respiratory distress
C. Hypervolemia
D. Peritonitis
Correct Answer: A. Disequilibrium syndrome
Disequilibrium occurs when excess solutes are cleared from the blood more rapidly than they can diffuse from the body’s cells into the vascular system. The dialysis disequilibrium syndrome is defined as a clinical syndrome of neurologic deterioration that is seen in patients who undergo hemodialysis. It is more likely to occur in patients during or immediately after their first treatment but can occur in any patient who receives hemodialysis.
Option B: Patients with end-stage renal failure treated by hemodialysis have a marked increased risk for cardiovascular death. These patients have both an accelerated form of arteriosclerosis with calcification in atheromatous intimal plaques and also medial calcification due to Monckeberg’s. In extreme cases, soft tissue calcification can lead to calciphylaxis resulting in skin ulceration, amputation, and death.
Option C: Having too much water in the body is called fluid overload or hypervolemia. One of the main functions of the kidneys is to balance fluid in the body. If too much fluid builds up in the body, it can have harmful effects on health, such as difficulty breathing and swelling.
Option D: Peritonitis is a peritoneal dialysis-related infection caused by bacteria entering the abdomen from outside the body and infecting the peritoneum. Bacteria may enter the body through the open ends of the PD catheter during exchanges.
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