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Discussion

Dialysis practice question

Practice exam question: 

A patient has rapid apical pulse, elevated BP, scattered rales, + 2JVD jugular vein distension, Pt may experience:
A. Cramping, nausea, Disequilibrium syndrome
B. Angina, hypotension, headache
C. Fever itching and anaphylaxis
D. Dyspnea hypotension and cramping

 

I don't think answer is C because itchiness is common when pt's diet is off or the lines have not been sterilized/cleaned efficiently.  What's the right answer?

 

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    I’d say A because it likely relates to the attempt to take off the huge amount of excess fluid the patient has on board. When you attempt to remove more fluid faster, patients often experience cramps and disequilibrium because the fluid being pulled from the third spaces into the vascular space can’t keep up with the pace the dialysis machine is taking fluid out of the vascular space.

    Incidentally this can also cause hypotension as the fluid from the third spaces tries to keep up with this pace. That’s why even when patients come to dialysis 5 or 6 liters positive, we have to call the MD and schedule extra treatments because we just can’t take that much off most people in a 3-4 hour treatment. (From a former dialysis tech!)

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    Should be B

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