patient temperature post dialysis

ageless · Apr 30, 2005

There are to many unknown variables to answer your question.

imperial · Apr 30, 2005

thanks :)

Jen,SN · Apr 30, 2005

I don't know why, but I see it pretty frequently at work--to the point where it's almost expected in our post-dialysis pts.

Maybe something to do with the massive moving and filtering of the blood sets off the inflammatory response? The cultures never come back positive....

nosonew, BSN, RN · Apr 30, 2005

This is NOT a normal reaction to dialysis. If a patient experiences a fever/chilling on dialysis, we draw blood cultures, contact the MD and generally give 1-2 antibiotics IV and await results.

If they develop a fever post dialysis above 101.5 degrees, they need to contact their nephrologist ASAP...

imperial · Apr 30, 2005

This is NOT a normal reaction to dialysis. If a patient experiences a fever/chilling on dialysis, we draw blood cultures, contact the MD and generally give 1-2 antibiotics IV and await results.
If they develop a fever post dialysis above 101.5 degrees, they need to contact their nephrologist ASAP...

thanks all... what is really strange is that the temp went away with tylenol, but apparently the patient has experienced this before wtih dialysis. Any ideas, staff at unit and doc say.. 'i don't know'...........hmm

KRVRN, BSN, RN · May 1, 2005

Why is it strange that the elevated temp went away with tylenol?

imperial · May 1, 2005

Sorry, did not mean strange that tylenol took temp down, strange that it happens after dialysis and no one knows why.... then it goes away. wonder if it could be some inflammatory process? thx. just trying to understand what happens with various pts.. considering when these questions asked of staff or doc they seem not to know.. :)

nosonew, BSN, RN · May 2, 2005

Likely that the patient is getting ill with "something"...hopefully it won't turn into sepsis..

imperial · May 3, 2005

Well, It certainly is interesting. We looked at the patient handbook which clearly states that a temp after dialysis, after the patient gets home, can be a reaction to the dialzyer.. The Rn stated NO... well, should we go with the RN or the handbook for patients that the unit gives with information? Then one neph said from the dialyzer .. ofcourse, the patient, to my recall is also taking zemplar although all labs are wnl... pth is only 190 or less... having some GI problems now. maybe just the stomach flu.. hopefully will go away,, oh yes, pt is also losing weight. Now, to our understanding if a pt is losing weight, without this being related to fluid being removed, it couldmean they need more dialysis time.. so we were told.. hmm. whoever said so many variables, so true.. but it is interesting to get such a wide variety of explanations.. and, actually, could be one of numerous things. thx.

JamaikanRN · Mar 29, 2011

If the blood culture results turn up neg then most likely, it is a reaction to the dialyzer membranes. New dialyzers for some people may trigger reactions, while others react to reprocessed dialyzers. Maybe if the dialyzer is allowed to rinse longer, then the reaction might stop... it's worth a try. wbc count results may also help to id the problem.