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Aloha,

1. What do you give a dialysis/diabetic patient who has low blood sugar?.....can't give him orange..can you give him apple juice...or milk?

What are juices acceptable to give dialysis, renal patients?

2. When patient returns from dialysis...what should the nurse assess for? What can go wrong when a patient returns from dialysis?

3. A dialysis patients wt. is taken before he goes to dialysis, immediately after dialysis on the dialysis unit and when he returns to the floor...what is the nurse supposed to do with this information?, the wts that have been taken?

4. A dialysis patient who is also a diabetic.....usually they get a early breakfast before dialysis.....and usually return about 1100....should there sugars be checked immediately? Should a snack be given immediately?

5. BP meds are held before dialysis...but are there other meds that should also be held? Won't the therapeutic affect of any meds given before dialysis be nullified because the fluid is being taken off? What if they need ativan or an analgesic?

6. Can sodium bicarb, phospho gel and any of those other similar meds for acid base balance be given without the patient eating? What if they are given and the patient doesn't eat?

Thanks for any answers given:uhoh3:

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Specializes in Hemodialysis, Home Health.
Aloha,

1. What do you give a dialysis/diabetic patient who has low blood sugar?.....can't give him orange..can you give him apple juice...or milk?

What are juices acceptable to give dialysis, renal patients?

2. When patient returns from dialysis...what should the nurse assess for? What can go wrong when a patient returns from dialysis?

3. A dialysis patients wt. is taken before he goes to dialysis, immediately after dialysis on the dialysis unit and when he returns to the floor...what is the nurse supposed to do with this information?, the wts that have been taken?

4. A dialysis patient who is also a diabetic.....usually they get a early breakfast before dialysis.....and usually return about 1100....should there sugars be checked immediately? Should a snack be given immediately?

5. BP meds are held before dialysis...but are there other meds that should also be held? Won't the therapeutic affect of any meds given before dialysis be nullified because the fluid is being taken off? What if they need ativan or an analgesic?

6. Can sodium bicarb, phospho gel and any of those other similar meds for acid base balance be given without the patient eating? What if they are given and the patient doesn't eat?

Thanks for any answers given:uhoh3:

Hi there ! :)

Will try to briefly answer some of these for you without going into too much depth...

1. a diabetic dialysis pt can have apple juice, grape juice, hard candy glucose tablets....if their sugar drops while on the machine.. or any other time. Just stay away from high potassium juices, fruits... oranges, bananas, tomatoes, etc.

2. monitor the patient for hypotension.. as fluid is pulled, it will cause the BP to drop significantly. Many patients feel weak and fatigued after treatment...they will perk up however in an hour or two.

3. Weights are obtained prior to tx to determine how much fluid weight the patient has gained since last tx., this tells the nurse how much fluid will need to be pulled that day.. how to program the machine to pull that amount. Weight is again obtained post tx. to see how successful the tx was in reaching the goal... and will let the nurse know just how much he/she(the patient) has gained from last post tx. weight to next pre tx. weight.

4.The patient's blood sugars are check just prior to initiating dialysis tx and again about 1/2 hour before the patient comes off the machine. Any concerns will be addressed at that time. Of course if the pt is symptomatic, this will be addressed right then. If the pt, is feeling poorly after dialysis and his/her glucose is low, offer him/her a snack. It is wise for diabetic dialysis patients to carry a bag lunch with them for when they come off the machine, and candy in their pocket for all other times.

5. You don't want to give any meds which will be dialyzed out... there is information available at most facilities and many other sources which provide this information. Certainly BP meds should be held until after dialysis.. as the blood pressure will drop anyway from the fluid removal during tx.

6. Phoslo in particular should ALWAYS be taken WITH the meal... it binds to the phosphate in the gut and thus removes the excess phosphorus from the body with the stool. It won't harm the pt to take it without food, but it would totally defeat the purpose.. it would be useless.. wouldn't do what the med is intended to do. So absolutely.. should be taken with or directly after a meal, snax, etc. Renagel also.. if I'm not istaken, it, too, is a phosphate binder.

Nephravites, etc. can be taken anytime.. but the phosphate binders should be taken WITH FOOD to accomplish its purpose.

Hope that helped. :)

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Specializes in Dialysis.

1. If the patient is symptomatic you are looking at intravenous glucose. If not I would try peanut butter and crackers.

2. Blood pressure, mental status, EKG disturbances. Dialysis changes the serum concentration of electrolytes but most of your potassium/magnessium/calcium stores are in the tissues/bones so there will be shifts in these immediately after dialysis. If you have a three liter change in intravascular volume that is obviously going to affect blood pressure and tissue/organ perfusion. Dialysis is exhausting on the body and most patients feel "wiped out".

3.You are aiming for a "dry weight" that has been determined by the physician for that particular patient. A liter of fluid is a kilogram is 2.2 pounds. The limiting factor for the dialysis nurse to remove fluid is hypotension, cramping, and nausea. Dialysis is a rollercoaster in fluid shifts that some hearts don't tolerate well.

4.Yes. Dialysate solution contains 200mg/dl of glucose so while on dialysis the patient's serum glucose will adjust to this level. When this source of sugar is removed blood sugar may drop.

5.Most antibiotics will dialyze out. Anything protein bound will not, the molecules are too big. Dilantin and digoxin are two that come to mind. If in doubt call, I appreciate a nurse that is thinking about these things. We have a wall chart in my unit to help us with these questions. Analgesics and sedation are OK to give even though some of the drug will be removed through dialysis. Don't let your patient be in pain just because dialysis is scheduled.

Hope that helps.

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Thank you Chisca and jnette.

You are both knowledgeable and helpful, extremely helpful. :yeah:

I love this site!

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Specializes in Hemodialysis, Home Health.
Thank you Chisca and jnette.

You are both knowledgeable and helpful, extremely helpful. :yeah:

I love this site!

You are quite welcome ! :)

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