Monitor Patient Closely Assignment Help: How to Answer This Question

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Original Question

Monitor the patient closely during dialysis to recognize hypotension, which is common. Heat transfer from warm solutions can result in vasodilation and a drop in blood pressure. When this occurs, reduce the temperature of the dialysate to 95°F (35°C). Fluid shifts from the plasma volume related to differences in electrolyte concentrations between hemodialysis (HD) solutions and blood also reduce blood pressure. Respond to modest declines in blood pressure by adjusting the rate of dialyzer blood flow and placing the patient in a legs-up (Trendelenburg) position. Respond to sustained or symptomatic hypotension by giving a fluid bolus of 100 to 250 mL of normal saline, albumin, or mannitol (if prescribed). A second bolus may be needed. If hypotension persists, new-onset myocardial injury or pericardial disease may be a contributing factor; respond by applying oxygen, reducing the blood flow, and notifying the primary health care provider urgently. Discontinue HD when hypotension continues despite two bolus infusions.

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