When I started in dialysis our units used only NS or Min UF, Decreased UF goal for Cramps. (Pushing on the foot, allowing the STABLE pt to stand as well)
The facilities I am in currently DO use hypertonic, Bicarb, D50 as well as Na modeling and UF profiles. These pts also gain excessively b/t tx and the cycle continues.
I have found here that with assessment (no edema, Lungs CTA (B) no SOB, statements of good appetitie, gaining weight, less active) many of these pt need increase DW. We as nurses are pt advocates and should (if protocols allow RN to increase DW)increase the DW and continue to monitor. DW's can change weekly.
I have seen many pt's stabilize with an increase in DW and no more cramps, no symptomatic hypotension.