student60

What would cause a patient to have chest pain a few hours post dialysis? We have discussed this and our Mgr says it is not related to dialysis. One of the nurses says it is as the dialysis treatment is stressful on the heart. The patient has not had a problem until recently (chest pain) but does have a history of angina. Any input would be great!. I know the SNS plays a part in this and it would make sense that it was related to dialysis. I think the Mgr does not want to think it is related to treatment as she might see this as 'doing something wrong' or 'blame' from the patient. ???????// :) :rotfl: :balloons: :uhoh21: :imbar

From my experience I can tell you NEVEr salary yourself. ALso, if you go to the CMS website, there is a great MDS section now with new info on RAPS. former NH staff.... :)

One of our patients experienced muscle (calf) bilateral pain, the day after dialysis, while walking. The pain increased to where she had to stop walking. DO patients have muscle pain, starting 19 hours post dialysis? She went to the ER and in ER the physician said that it was due to fluid shifting.

Again I am being given different information. You all are experienced and I need your resources. Patient usually has TMPs 40 -50 with AP/VP in upper 100's (180). The other day the TMP was +10. This is first time for "+". The AP/VPs were lower 150/130. Various explanations and teaching I have been given are. A. Dialyzer clotting B. Related to patient's hgb being higher C. Not a problem D. Should not have "+" sign in front and signifies a problem HELP!!!:angryfire

Do you prefer to cannulate with or without tourniquet, and why, for your preference? Do you find advantages or disadvantages?

You are a good nurse and will be throughout your career. Do not let those who do not care about patients sway you or influence you. They should be reported. keep your documentation of what happens in your unit in case something happens you have who said what to whno. I was told to keep a journal when I am told different things from different staff whoa re teaching me. Your own personal journal for your protection. Keep up the good work and get those others out of patient contact. They are putting patients in danger

My new job is going well. We have a few patients who have had their bolus heparin decreased. One to 1K and one to 500U. Both patients continue to have minimal oozing post dialysis, several hours after treatment. I am told by one that it is due to heparin, another tells me it can be other factors. Any ideas? The techs at my unit tell patients it is heparin as cause but in training book stated stenosis? ideas?

Thanks. I try to be very kind and caring, not sure what I would do as a dialysis patient.

This particular patient urinates and a minimal amount of fluid is removed and often her pre weight is same as prior post weight or slightly higher.

We have a patient who c/o being wiped out/exhausted/tired and 'feels bad' post dialysis (several hours). One nurse suggested to Doctor to increase dialysis time by 15 minutes, another said 'just happens'. Any feedback.

Thank you. Our unit (FMC) we are told, if patient asks, to tell them it is ok at 1/2 full or less and not to worry until it is empty.

Quite upsetting. We are told does not have to be even 1/2 full and to tell patients, if they ask, that it is ok if 1/2 full or less as long as it is not empty. FMC unit

Do all dialysis units have routine orders for changing the dialysate prescription? What determines a change in K+. For example, at what level (K+) is the dialysate changed from 2 to 3, or 3 to 2. Thanks, like to hear what other units are doing and if there are community standards Tx.

This is what I was originally told. 3/4 full. Now, I am being told to leave until blood gets to bottom of chamber. Is there an alarm on the K machine when the blood reaches a certain level whereby it needs to be filled? Why would the charge nurse tell me not to fill until it is low or not to fill if it is 1/2 full? We are a busy small unit but isn't this unsafe for the patient? I thought I read, in orientation that it was to be 3/4 full. I told this to the charge nurse but she insists I do what she says. QUOTE=donroberto]Keep the arterial and venous chambers 3/4 full...applys to both k and h machines. QUOTE=student60]Hello Group Members: Can someone please tell me what is right and what should be done. I am being given different information from nurses about the chambers. First, I was told the chambers could be 1/2 full but not to let them get under 1/2 full. Then I am told to just let them run their course until they are empty. Now, on the 2008K machine is there an alarm that goes off when the chamber needs to be filled? Are there side effects that my patients will experience if the chambers get low to about 30 cc of blood left? Thanks.

Hello Group Members: Can someone please tell me what is right and what should be done. I am being given different information from nurses about the chambers. First, I was told the chambers could be 1/2 full but not to let them get under 1/2 full. Then I am told to just let them run their course until they are empty. Now, on the 2008K machine is there an alarm that goes off when the chamber needs to be filled? Are there side effects that my patients will experience if the chambers get low to about 30 cc of blood left? Thanks.