A client receiving hemodialysis treatments wants to take a multivitamin supplement several times a day. Which direction should the nurse provide to this client?
a. "All water-soluble vitamins are removed by dialysis."
b. "The most common vitamin deficiency is B12, so take that."
c. "Vitamins are not toxic and extra amounts will not cause harm."
d. "Avoid vitamins that are fat soluble because they are not removed by dialysis."
d. "Avoid vitamins that are fat soluble because they are not removed by dialysis."
Fat-soluble vitamins are not removed during dialysis and should not need to be replaced. There can be some deficiencies in water-soluble vitamins and there is some evidence that one multivitamin a day may be beneficial, but there are no recommendation for more than one a day. Excess amounts of vitamins are not recommended and can be harmful. Not all water-soluble vitamins are lost during dialysis. Vitamin B12 is protein bound and not removed by dialysis.
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