The client is hypotensive after hemodialysis. Which does the nurse implement to prevent complications from hypotension?
1. Provides warm blankets
2. Elevates the head of the bed
3. Instructs client to move slowly
4. Puts client on seizure precautions
3
3. One purpose of hemodialysis is to remove excess fluid from the client; in the process, massive fluid shifts occur. The fluid loss increases the risk of client hypo-tension after therapy and client injury because of orthostatic hypotension and dizzi-ness, so the nurse instructs the client to change positions slowly to avoid dizziness when getting up or changing positions too quickly.
1. Providing warm blankets is indicated after hemodialysis despite the client's hypo-tension because the dialysis process involves instilling cold fluid and removing warm body fluids, leading to a decrease in client temperature; however, increasing the client's core temperature facilitates vasodilation and potentially can cause hypoten-sion.
3. Elevating the head of the bed in the presence of hypotension is contraindicated because positioning the head in an independent position facilitates venous return to decrease the blood flow to the brain.
4. Massive fluid and electrolyte shifts during hemodialysis increase the risk of client seizures regardless of a client history of no seizures.
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