A client is undergoing hemodialysis. The client's blood pressure at the beginning of the procedure was 136/88 mm Hg, and now it is 110/54 mm Hg. What actions should the nurse perform to maintain blood pressure? (Select all that apply.)
a. Adjust the rate of extracorporeal blood flow.
b. Place the client in the Trendelenburg position.
c. Stop the hemodialysis treatment.
d. Administer a 250-mL bolus of normal saline.
e. Contact the health care provider for orders.
ANS: A, B, D
Hypotension occurs often during hemodialysis treatments as a result of vasodilation from the warmed dialysate. Modest decreases in blood pressure, as is the case with this client, can be maintained with rate adjustment, Trendelenburg positioning, and a fluid bolus. If the blood pressure drops considerably after two boluses and cooling dialysate, the hemodialysis can be stopped and the health care provider contacted.
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