The client becomes lightheaded toward the end of the HD and the nurse determines the client has hypotension. Which should the nurse implement so dialysis can finish?
1. Administer IV fluids.
2. Order a unit of blood.
3. Increase rate of dialysis.
4. Lower head of the bed.
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4. The client is hypotensive and lightheaded because of fluid loss from HD and the resultant massive fluid shifts. To facilitate blood flow to vital organs, the nurse lowers the head of the bed and raises the client's feet as tolerated to drain blood from the legs for vital organs; however, the nurse implements these interventions cautiously and according to agency policy. To avoid life-threatening complications, dialysis should stop if conservative measures do not stabilize the client rapidly.
1. The nurse avoids administering additional IV fluids because one purpose of HD is to remove excess fluid volume.
2. Clients on HD frequently receive blood because it is easily administered through the dialysis pump and because clients with renal failure have chronic anemia. The nurse can collaborate with the provider about the hypotension to determine the need for blood.
3. The dialysis is primarily a function of the dialysate mixture and the length of pump time. The rate of dialysis is limited by pressure ranges the operator implements di-alysis; to increase the rate of dialysis, the concentration of the dialysis must be in-creased.
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