Hemodialysis

Hemodialysis

Category / Primary Body System

• Renal System

Problem

• Patient is at risk for complications due to hemodialysis treatments.

Goal

• Patient’s dialysis access line will remain patent for the next 90 days.

Plan/Approach

1. Medication Administration

   • Administer medications as per MD order to manage and support the patient’s condition during hemodialysis.

2. Transportation

   • Provide transportation to the dialysis center as scheduled to ensure timely treatments.

3. Laboratory Tests

   • Conduct labs per MD order to monitor the patient's kidney function, electrolytes, and overall health status.

4. Dietary Management

   • Provide diet per MD order to ensure the patient is receiving appropriate nutrition while managing fluid and electrolyte balance.

5. Weight Monitoring

   • Weigh the patient as ordered to monitor fluid status and detect signs of fluid overload.

6. Access Line Monitoring

   • Monitor the dialysis access line for bruit and thrill every shift to ensure patency and detect any issues early.

7. Fluid Overload Monitoring

   • Monitor for signs and symptoms of fluid overload such as swelling, shortness of breath, and rapid weight gain, and notify MD if any are observed.

8. Communication with Dialysis Center

   • Communicate with the dialysis center regarding the patient’s care as needed to ensure coordinated care and address any issues that arise.

9. Dialysis Access Device Management

   • Ensure proper care and management of the dialysis access device, including regular inspection and hygiene practices.

10. Documentation and Scheduling

    • Maintain accurate documentation of access location, dialysis schedule, and any relevant observations.

Rationale

1. Medication Administration

   • Proper medication management is crucial for maintaining the patient’s health and preventing complications during hemodialysis.

2. Transportation

   • Reliable transportation ensures the patient does not miss any dialysis sessions, which are critical for their health.

3. Laboratory Tests

   • Regular lab tests help monitor the patient's health and adjust treatment plans as necessary.

4. Dietary Management

   • A tailored diet supports the patient’s nutritional needs while managing fluid and electrolyte balance.

5. Weight Monitoring

   • Monitoring weight helps detect fluid retention early, preventing complications.

6. Access Line Monitoring

   • Ensuring the patency of the access line is vital for effective dialysis and preventing complications.

7. Fluid Overload Monitoring

   • Early detection of fluid overload allows for prompt intervention, reducing the risk of severe complications.

8. Communication with Dialysis Center

   • Effective communication ensures all care providers are aware of the patient’s needs and any changes in their condition.

9. Dialysis Access Device Management

   • Proper care of the access device prevents infections and other complications.

10. Documentation and Scheduling

    • Accurate documentation and adherence to the dialysis schedule ensure continuity of care and timely treatments.

Actions

1. Medication Administration

   • Administer prescribed medications and monitor for side effects and effectiveness.

2. Transportation

   • Coordinate and provide transportation to the dialysis center as scheduled.

3. Laboratory Tests

   • Draw labs as ordered, monitor results, and report to the attending physician.

4. Dietary Management

   • Provide meals and snacks according to the prescribed diet and educate the patient on dietary restrictions.

5. Weight Monitoring

   • Weigh the patient daily or as ordered, document the weight, and report significant changes to the healthcare team.

6. Access Line Monitoring

   • Check the dialysis access line for bruit and thrill every shift and document findings.

7. Fluid Overload Monitoring

   • Monitor for signs of fluid overload such as edema, shortness of breath, and rapid weight gain, and notify the MD if observed.

8. Communication with Dialysis Center

   • Regularly communicate with the dialysis center about the patient’s condition, treatment responses, and any concerns.

9. Dialysis Access Device Management

   • Perform regular inspections and hygiene practices to ensure the dialysis access device is functioning properly.

10. Documentation and Scheduling

    • Maintain detailed records of access site inspections, dialysis schedules, and any observations related to the patient’s condition.