what's the most important things to know about Dialysis patient??

Specialties Urology

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I am a new nurse, just got a new patient on our unit (LTC) I am going to read up on kidney failure in my nursing books. What is the most important thing I should know about dialysis patients, assessments to look for when returning from dialysis. Just thought some of you experienced Dialysis nurses would have some good information/tips for me.

Thanks,

Bea

If your house bowel protocol includes milk of mag dialysis patients can not have it.

Specializes in Trauma Surgical ICU.

Check out and know the renal diet. Many pts can not have most things we take for granted... BP, weights and lung sounds are key in HD pts as well as the graft/fistula site, check it for bleeding.

You can be a great help to the dialysis team, because your eyes and ears have more access to the patient than ours. Kudos to you for taking an interest in playing an active part in your patient's disease process.

Every dialysis patient is different depending on many factors including their own unique comorbidities such as diabetes and heart disease, and degree of renal failure (some patients still urinate and have what we call "residual renal function" meaning they still clear some "toxins" on their own).

I'll echo sun0408 in that fluid status, post-dialysis BP's, and checking the dialysis graft (assuming he or she has one, and not a dialysis catheter) daily for a thrill and bruit.

If your patient is diabetic, a blood sugar reading before you send them to their treatment can help avoid crises.

If your patient takes phosphorous binders...they are useless unless given WITH meals. Can't tell you how many times I see RN's giving them two hours post prandial.

If your patient has minimal to no urine output...watch them because LTC dialysis patients are notorious for "sneaking" fluids. Fluid overload is a huge concern with many of our patients.

Thank you for your comments, this is all new information to me seeing I am such a" newbie" but I plan on reading up as much as I can and becomming educated seeing so many patients seem to be becoming dialysis patients :(

Specializes in Geriatrics.

Please send your pt to dialysis with good hygein, they can't do it themselves. Great question!

If they have a catheter, leave the dressing on. It will be changed at dialysis and needs to be kept clean and DRY! Do not ever draw labs from the dialysis cath. If they have a graft or fistula the pressure dressing may be removed 4-6 hours after treatment. If they ever start bleeding post treatment from the graft or fistula this is life threatening, they can bleed out very quickly, so hold pressure for 10 minutes at LEAST before checking to see if bleeding has stopped. If this happens often or more than once, call the md.

Question any orders for iv fluids, these patients suffer from overload and sometimes when admitted to a med surg type floor the hospitalist orders iv fluids.

Check with the dialysis center for what meds to hold before dialysis, some meds dialize out and some meds (BP) will drop their bp too much during treatment. Whereas other patients bp gets sky high, so it will depend on the patient.

Please please make sure they are toileted, dressed appropriately, fed, and have their dialysis bag when heading out the door. They usually have a blanket, headphones, and a pillow. Dialysis gets very cold and they will suffer without a blanket. We are not allowed to keep or provide blankets due to infection control regulations in the center.

Specializes in Nephrology.

Thank you so much for asking! I think sometimes nurses are nervous about asking us for fear of looking like they don't know. Dialysis is a very specialized field and you have to work there to really know it!

Read this thread, it has a lot of good information in it. If you still have questions, feel free to ask away!

https://allnurses.com/dialysis-renal-urology/what-should-every-513867.html

Do not talk to them as children and do not be a control freak.

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