stressful situations in dialysis
- 0Feb 9, '13 by ffliper27Hi:
I would like to receive advice from experienced dialysis RNs. I may get a job offer as a new dialysis RN fairly soon. I just don't know what kind of emergencies (life or death scenarios) can possibly arise while patients are receiving dialysis treatment. I have heard that patients may code / have strokes during treatment. Is this actually possible? How often are these situations likely to arise? what interventions would be employed to remedy such cases?
Also, what is a typical day like for dialysis RN's in general?
If anyone of you can offer some feedback on this topic, it would be really appreciated.
- 0Feb 9, '13 by traumaRUs, MSN, APRN, CNS AdminIm an APN in 4 outpt dialysis units. Ive been at this job for almost 7 years. On average I have about one code a month and thats covering about 215 pts. Yes, codes can and do happen during dialysis. These are very ill pts to begin with. They also can stroke - again you are dealing with very frail individuals. Ive never been a dialysis RN so cant answer to those questions.
- 0Feb 10, '13 by ChiscaOne quarter of all dialysis patients become hypotensive during a treatment. Some worse than others. Depending on how you respond you may rescue your patient from coding or not. Some will have autonomic dysfunction while others will just have a big floppy heart. You also get to deal with swings in potassium and calcium levels that tend to irritate the heart. A strong cardiac background would definitely be an asset.
- 0Feb 10, '13 by Sun0408Quote from traumaRUsWow, impressiveOutpt is becoming more technical too....we have had pts with LVADs, vents, other ongoing IV gtts for pulmonary HTN.
Before going to the ICU, I was a floor nurse on a renal floor but they were "stable" came in for the usual missed HD, fluid overload, HTN crisis etc but no gtts or vents on the floor.. The ICU, we get them. Thankfully HD nurse comes to us for the unstable vented, multi gtt pt.
- 0Feb 10, '13 by sonhotIt can be pretty routine. So don't let that alter you're attention. Usually they are mostly BP issues. A good pre assessment is essential. Once you know your PT's (if in chronic unit like me)
you can be pro active with there tx I've been doing this 13 yrs. I've never delt with air embolism or hemolysis. I've delt with codes. Keep up on CPR. Where I work we start CPR and activate EMS and they take over. Nurse 9