Dialysis is an essential treatment for people with chronic kidney disease. It removes waste and excess fluid from the body to help reverse the effects of kidney failure which is often caused by diabetes, high blood pressure, and end-stage renal disease.
During dialysis, blood is cleaned in an artificial filter called a membrane. However, this process can be stressful on your body, which may lead to some common concerns among dialysis patients. These include dehydration, low potassium levels, and feeling unwell after dialysis. If you are a dialysis patient, here are some common nursing concerns you may experience:
These conditions render dialysis patients particularly vulnerable to complications and risk factors that, if left unattended, can lead to severe illness or even death.
Because of this, it’s important for dialysis nurses to be vigilant about the health of their patients and to keep an eye out for potential problems during dialysis treatments.
Here are several key concerns nurses at any dialysis clinic must consider and address regularly when working with their patients.
Dialysis Treatments: An Overview
When your kidneys are not working well enough or don’t work, you need dialysis treatments for your health to improve. To perform dialysis, blood must flow through a filter into an artificial kidney (dialyzer) made of semipermeable membranes.
During this process, impurities and fluids are removed from the blood. The clean blood flows back into your body after passing through the dialyzer. The degree of the illness determines whether to opt for nursing home dialysis or an outpatient clinic.
What is Nursing Home Dialysis?
Nursing home dialysis is a type of dialysis that is typically performed on nursing home residents. This type of dialysis can be performed as either hemodialysis or peritoneal dialysis.
The main difference between nursing homes and outpatient clinics is that nursing home dialysis is typically performed more frequently. Nursing home patients also usually require the assistance of a nurse.
A skilled nursing facility-based dialysis patient will undergo two weekly sessions, each lasting 3-4 hours. They may be asked to go through additional sessions depending on their medical needs. With this type of treatment, the patient’s blood will go through an artificial kidney machine which filters out excess fluids and wastes from the body before going back into circulation.
Common Concerns Associated With Dialysis
Most patients experience pain in their abdomen and shortness of breath during dialysis. It’s also common for them to become thirsty due to low sodium levels.
Other concerns include:
Hypotension
Hypotension or low blood pressure can be caused by various factors, including dehydration, blood loss, and certain medications. Treatment for hypotension usually involves giving the patient fluids intravenously. However, monitoring the patient closely is important, as too much fluid can lead to problems. Nurses must consider the cause of the issue when treating hypotension to provide appropriate treatment.
If blood loss is a concern, administering IV fluids may not be enough; replacement transfusions are necessary. In addition, it’s important to maintain adequate nutrition levels in patients with kidney disease because malnutrition will lead to an increased risk of complications like heart failure and bone disease; this requires close monitoring by a dietitian or a dialysis provider.
Fluid Overload
Blood becomes thicker when there is too much fluid; this can cause swelling of limbs, respiratory difficulties, and joint stiffness. One last concern that many patients have during dialysis is bone marrow suppression. That’s because heparin is used during the treatment and can lead to decreased production of platelets and red blood cells, weakening the immune system and making one more susceptible to infection.
Oliguria
Among the most common nursing concerns during dialysis is oliguria or low urine output.
A few things can cause oliguria, including dehydration, kidney disease, and certain medications. To help manage oliguria, nurses should encourage patients to drink plenty of fluids and closely monitor their intake and output. In some cases, IV fluids may be necessary.
Ineffective Breathing Pattern
Ineffective breathing patterns can be caused by various factors, including anxiety, pain, and shortness of breath. To help your patients cope with this concern, it’s important to provide support and reassurance, especially middle-aged dialysis patients. You can also encourage deep breathing exercises and relaxation techniques. If you notice any changes in your patient’s breathing pattern, report them to the doctor immediately.
Infection Risk
One of the most common nursing concerns in dialysis is infection. Patients with weak immune systems are at a higher risk for infection. Nursing home dialysis patients need frequent skin checks and mouth care. Encourage your patient to avoid contact with people who have symptoms of infection, such as fever, cough, sore throat, redness around their eyes or mouth, or who have recently been ill and might be contagious.
Patients need nurses during dialysis because they are experts in managing these concerns, which dialysis patients might experience before, during, or after the process. In addition, they ensure the patient’s safety and act as guides to help them understand what is happening in their bodies.
What the Nurse Monitors During Dialysis
As a nurse, you are responsible for monitoring your patient’s vitals and changes in condition during dialysis. You are also responsible for maintaining their access, ensuring their fluids are properly balanced, assisting with nutrition, and managing any medications they may be on.
In addition, you will have to monitor patients closely if they are on dialysis because of the high risk of developing heart disease and other illnesses.
The nursing management for dialysis is to keep the patient hydrated and assist with nutrition, provide emotional support, prevent and treat infections, and manage pain.
Explore the Four Seasons Dialysis Center
The average life expectancy of someone on dialysis is 5-10 years. However, many factors can affect this number, including the patient’s age, overall health, and compliance with treatment.
That said, it’s important that nurses are aware of the potential issues that can arise during dialysis treatment. By understanding the most common concerns, they can be better prepared to handle any situations that may come up.
At Four Seasons Healthcare Solutions, we offer effective and flexible treatment to our family of clients. Our dialysis clinics include community dialysis, outpatient dialysis, and nursing home dialysis.
Contact us today for more information on how we can help your loved one receive the best possible care from our dialysis providers.
