Question

A patient with a history of end-stage renal disease secondary to diabetes mellitus has presented to the outpatient dialysis unit for his scheduled hemodialysis. Which of the following assessments should the nurse prioritize before, during, and after his treatment?

1) Level of consciousness
2) Blood pressure and fluid balance
3) Temperature, heart rate, and blood pressure
4) Assessment for signs and symptoms of infection

Answer 1

Before, during, and after hemodialysis treatment, nurses should focus on assessing blood pressure and fluid balance, level of consciousness, temperature, heart rate, and blood pressure, and check for signs and symptoms of infection under the direct supervision of a registered nurse.

Step-by-step explanation:

When caring for a patient with end-stage renal disease (ESRD) secondary to diabetes mellitus on hemodialysis, the nurse should prioritize the following assessments under the direct supervision of a registered nurse:

1. Blood pressure and fluid balance to monitor for hypotension or hypertension and fluid overload or deficit.
2. Level of consciousness to assess for any changes that may indicate complications such as disequilibrium syndrome.
3. Temperature, heart rate, and blood pressure to detect any signs of infection, cardiac issues, or other immediate concerns.
4. Assessment for signs and symptoms of infection, particularly at the access site for dialysis.

It is critical to focus on these areas because they are essential for providing safe and effective dialysis treatments. These assessments help in preventing and identifying complications early so that they can be managed promptly.