What meds do dialysis nurses give to patients in the clinic?

[MTRNlove, BSN]

Im curious as to what meds you are working with as a dialysis nurse. Are there many meds involved? If so, how do they help the patient undergoing dialysis? I'm asking because I'm thinking of getting into this specialty and want to understand it more clinically. Tia!

[Zeek, LPN]

At most units the patients are given an ESA (Erythropoesis Stimulating Agent) which helps them to build red blood cells as their kidney no longer produces erythropoetin; IV iron products to help them make the red cells; the activated form of Vitamin D called Calcitriol (there are other trade names for this, but again, with damaged kidneys the body can't convert D2 to D3) and some Calcimimetics which help with  PTH levels and Ca  lcium balance.  We do give antibiotics for infections and use heparin and lidocaine for treatments as well.  Some units have meds for high BP like Clonadine or for low BP like Midodrine; nausea meds, benadryl, tylenol etc.  Most of the meds are oral except for the ESA and iron.  

We give some of these meds in center because they are tied to the bundle of services which is how we get paid to do a treatment.  I think many people think of dialysis nursing as an assembly line - put them on- take them off.  There is so much more to it!  You use all your assessment skills and can head bad outcomes off at the pass - I have caught DVT's in a patient who just returned from the hospital and one nurse at our unit caught a pericardial friction rub from pericarditis!  It is technical on one side and in our unit nurses do everything a tech can do so we all work together as a team.  A good basic book is "Review of Hemodialysis for Nurses and Dialysis Personnel" by Judith Kallenbach.  It is a very basic book that you can find on Amazon.  I would encourage you to try it.  Not everyone likes it, but it can be a fun and rewarding job!

[MTRNlove, BSN]

22 hours ago, rhyde said:

At most units the patients are given an ESA (Erythropoesis Stimulating Agent) which helps them to build red blood cells as their kidney no longer produces erythropoetin; IV iron products to help them make the red cells; the activated form of Vitamin D called Calcitriol (there are other trade names for this, but again, with damaged kidneys the body can't convert D2 to D3) and some Calcimimetics which help with  PTH levels and Ca  lcium balance.  We do give antibiotics for infections and use heparin and lidocaine for treatments as well.  Some units have meds for high BP like Clonadine or for low BP like Midodrine; nausea meds, benadryl, tylenol etc.  Most of the meds are oral except for the ESA and iron.  

We give some of these meds in center because they are tied to the bundle of services which is how we get paid to do a treatment.  I think many people think of dialysis nursing as an assembly line - put them on- take them off.  There is so much more to it!  You use all your assessment skills and can head bad outcomes off at the pass - I have caught DVT's in a patient who just returned from the hospital and one nurse at our unit caught a pericardial friction rub from pericarditis!  It is technical on one side and in our unit nurses do everything a tech can do so we all work together as a team.  A good basic book is "Review of Hemodialysis for Nurses and Dialysis Personnel" by Judith Kallenbach.  It is a very basic book that you can find on Amazon.  I would encourage you to try it.  Not everyone likes it, but it can be a fun and rewarding job!

Thank you so much for explaining! Do you have to give narcs of any kind? I'm trying to get out of LTC because I hate giving heavy drugs to people. There's an overuse of benzos and opiods in facility nursing and I think it's wrong.

[Hoosier_RN, MSN]

No narcs at all. If a patient takes narcs, it is self supplied, self administered. In the clinics I've worked in, it's been discouraged, as anyone can steal narcs. If narcs aren't in the clinic, they can't be stolen 

[MTRNlove, BSN]

2 hours ago, Hoosier_RN said:

No narcs at all. If a patient takes narcs, it is self supplied, self administered. In the clinics I've worked in, it's been discouraged, as anyone can steal narcs. If narcs aren't in the clinic, they can't be stolen 

Oh yeah! That's a big draw for me. Thank you for your response☺

[SmilingBluEyes]

It's one of the best parts of dialysis; no narcotics. I don't like being accountable for them.

[integrativenurse]

One of the positives in working in chronic dialysis...not too many drugs. You got the ESA, vitamin D analogs, calcimimetics, iron, acetaminophen, antiemetic, one type to bring BP up and another type to bring it down, Benadryl, IV antibiotics types that you can count on one hand. Potential drug criminals don't even attempt to rob supply trucks and med deliveries because they know they'll just be disappointed!