dialysis question

Hi I'm a student and I had a few questions about dialysis. So when your patient is getting dialysis... there's no point in giving them any medications because it will be dialysised out, right? Does this include everything... even tylenol and insulin? Do insulin needs change pre and post dialysis... do you even given insulin before their treatment? Was it stupid that a MD ordered a 24 hour urine for protein on a patient getting dialysis?

Many medications do get dialyzed out during tx., but there are some which do not.

You can certainly give insulin during tx. if neccessary. The dialysate bath the patient is on will usually balance out the blood sugar, however. If it's too high it will bring it down, if too low, it will raise it.

But if their sugar is very high (ie. > 300) we give them 5 units of regular insulin in their line if they haven't taken their insulin right before coming to tx. We also give 50 ml dextrose if their sugar is quite low AND they are symptomatic.

We give their tx. meds while they are dialyzing as well.. epogen, zemplar, iron. And antibiotics IV during the last hour of tx.

We have a med guide or list that shows which meds dialyze out and which don't.

We do give tylenol during tx. as well.

:)

The articifical kidney has pores. The pores are smaller than blood cells, but bigger than waste products. The waste products slip right through to the other side and are removed, but the blood cells remain in the blood. If the molecular size of the medication in the blood is small enough and it is free-floating, the medication can be dialyzed out.