Dialysis Complications and Emergency Management Flashcards
6 cards from real CHT practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
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Intradialytic hypotension (IDH) is most commonly defined as a systolic blood pressure drop of more than:
Answer: 20 mmHg or to below 90 mmHg systolic
IDH is typically defined as a systolic BP drop ≥20 mmHg or a decline to below 90 mmHg, often accompanied by symptoms requiring intervention.
The most appropriate immediate response when a patient develops severe muscle cramps during dialysis is:
Answer: Administer hypertonic saline or dextrose, and reduce the ultrafiltration rate
Muscle cramps during dialysis result from rapid osmotic shifts and volume depletion; treatment includes reducing ultrafiltration rate and administering hypertonic solutions.
Air embolism during hemodialysis most commonly enters the extracorporeal circuit through:
Answer: Loose connections or tubing cracks on the arterial (pre-pump) side
Air most commonly enters the circuit through loose needle connections, cracked tubing, or accessory ports on the arterial (negative pressure) side of the blood pump.
The immediate action when air embolism is suspected during hemodialysis is:
Answer: Clamp the venous line, stop the blood pump, and position patient in left lateral Trendelenburg
Clamping the venous line and stopping the pump prevents more air from entering; left lateral Trendelenburg traps air in the right ventricle apex away from the pulmonary vasculature.
Dialysis disequilibrium syndrome is most likely to occur in which patient population?
Answer: First-time dialysis patients with very high BUN levels
Dialysis disequilibrium occurs most often in first-time dialysis patients with severely elevated BUN, as rapid urea removal creates osmotic gradients causing cerebral edema.
When a patient experiences nausea, vomiting, and falling blood pressure during dialysis, which intervention should be performed FIRST?
Answer: Lower the head of the bed, reduce ultrafiltration rate, and assess BP
Initial management of intradialytic hypotension with nausea includes Trendelenburg positioning and reducing ultrafiltration while assessing the degree of hemodynamic compromise.