nausea post dialysis

[LPN2RNBSN]

Can anyone provide information re patients c/o nausea (slight/minimal) after dialysis - about one hour...ofcourse, it could be from too much fluid removal, however, when several patients c/o same s/s could there be other reasons i.e. water problems? dialysate problems? I did check labs for these patients and it seems that all labs - routine monthly - FMC.. are wnl. thx.

[NeosynephRN]

A big problem that we saw in our unit was that about at that time...many of the patients blood sugars would drop. So many dialysis patients are diabetics and with the added glucose in the dialysate, this was a common problem...not to mention that (in our unit) the patients are not allowed to eat on TX..many would go hypoglycemic on us and feel nauseous and dizzy and just cruddy. just a thought

[DeLana_RN, BSN, RN]

Frankly, I don't know - I don't recall any such c/o in my 5+ years in a chronic unit. Nausea due to excessive UF and/or hypotension is usually sudden-onset and relieved with NS and/or rinseback.

Regarding diabetics, since the glucose in the dialysate is just under 200, I doubt it would drop that much right after dialysis, but perhaps if they still don't eat once they get off the machine it could (but I would suspect lightheadedness rather than nausea as a main symptom?)

DeLana

[cwnurse1]

are diabetics allowed to eat a small snack during treatment? they go a long time without eating. if it is related to the machine, is everyone coming off that machine feeling the same?

[MSLNT1.1]

I would suggest finding out from your patients did they eay prior to coming to treatment and if they checked their glucose before administering their insulin. I had a patient just the other day who became nauseated post tx and when I checked her glucose it was low. After I asked her, she said she had not eaten at all and I given herself the insulin and because her transportation was late she went well over 5 hours without any food. So although eating is not encouraged, diabetic's need to be looked at individually particularly those who come for the 1st shift because they either are not eating or they go too long during tx and it is lunch time and there is a delay in eating and they have no snacks with them. In regards to the water the opposite usually occurs, the patient tends to feel better if it is a water issue because they are no longer exposed. Also are the patients on the same RO loops or are they different?

Dialysis Educator