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
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Medication Administration
- Administer medications as per MD order to manage and support the patient’s condition during hemodialysis.
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Transportation
- Provide transportation to the dialysis center as scheduled to ensure timely treatments.
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Laboratory Tests
- Conduct labs per MD order to monitor the patient's kidney function, electrolytes, and overall health status.
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Dietary Management
- Provide diet per MD order to ensure the patient is receiving appropriate nutrition while managing fluid and electrolyte balance.
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Weight Monitoring
- Weigh the patient as ordered to monitor fluid status and detect signs of fluid overload.
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Access Line Monitoring
- Monitor the dialysis access line for bruit and thrill every shift to ensure patency and detect any issues early.
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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.
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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.
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Dialysis Access Device Management
- Ensure proper care and management of the dialysis access device, including regular inspection and hygiene practices.
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Documentation and Scheduling
- Maintain accurate documentation of access location, dialysis schedule, and any relevant observations.
Rationale
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Medication Administration
- Proper medication management is crucial for maintaining the patient’s health and preventing complications during hemodialysis.
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Transportation
- Reliable transportation ensures the patient does not miss any dialysis sessions, which are critical for their health.
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Laboratory Tests
- Regular lab tests help monitor the patient's health and adjust treatment plans as necessary.
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Dietary Management
- A tailored diet supports the patient’s nutritional needs while managing fluid and electrolyte balance.
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Weight Monitoring
- Monitoring weight helps detect fluid retention early, preventing complications.
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Access Line Monitoring
- Ensuring the patency of the access line is vital for effective dialysis and preventing complications.
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Fluid Overload Monitoring
- Early detection of fluid overload allows for prompt intervention, reducing the risk of severe complications.
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Communication with Dialysis Center
- Effective communication ensures all care providers are aware of the patient’s needs and any changes in their condition.
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Dialysis Access Device Management
- Proper care of the access device prevents infections and other complications.
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Documentation and Scheduling
- Accurate documentation and adherence to the dialysis schedule ensure continuity of care and timely treatments.
Actions
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Medication Administration
- Administer prescribed medications and monitor for side effects and effectiveness.
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Transportation
- Coordinate and provide transportation to the dialysis center as scheduled.
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Laboratory Tests
- Draw labs as ordered, monitor results, and report to the attending physician.
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Dietary Management
- Provide meals and snacks according to the prescribed diet and educate the patient on dietary restrictions.
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Weight Monitoring
- Weigh the patient daily or as ordered, document the weight, and report significant changes to the healthcare team.
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Access Line Monitoring
- Check the dialysis access line for bruit and thrill every shift and document findings.
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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.
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Communication with Dialysis Center
- Regularly communicate with the dialysis center about the patient’s condition, treatment responses, and any concerns.
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Dialysis Access Device Management
- Perform regular inspections and hygiene practices to ensure the dialysis access device is functioning properly.
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Documentation and Scheduling
- Maintain detailed records of access site inspections, dialysis schedules, and any observations related to the patient’s condition.
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