NORCET 3 - 2022 (Shif…: A patient is going to Haemodialysis then after the procedure what will be the possible symptoms, except?

NORCET 3 - 2022 (Shift-1)

Medical & Surgical Nursing

Medium

Appeared in: NORCET 3 - 2022 (Shift-1)

Explanation

the one finding that is not expected after hemodialysis.
Hemodialysis is associated with a risk of intradialytic hypoxemia, which is a decrease, not an increase, in arterial oxygen levels.
This hypoxemia can be caused by factors like complement activation triggered by the dialyzer membrane, which leads to white blood cells accumulating in the lung capillaries, impairing gas exchange.
Therefore, an increase in arterial oxygen is physiologically inconsistent with the known potential complications of the procedure.

Option A: Weight loss is an expected and intended outcome of hemodialysis.
Option B: Anaemia is a very common and expected chronic condition in patients requiring hemodialysis.
Option C: While hypotension is more common, a paradoxical increase in blood pressure (intradialytic hypertension) is a recognized, though less frequent, complication.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Complications and expected outcomes of hemodialysis in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Post-dialysis assessment is a critical nursing responsibility. This includes monitoring for hypotension, checking for bleeding at the access site, and assessing the patient's overall well-being.
Understanding the difference between expected outcomes (weight loss) and potential complications (hypotension, hypoxemia, cramps) allows the nurse to intervene promptly and ensure patient safety.
What if? If a patient complains of sudden chest pain and shortness of breath during dialysis, the nurse's priority is to assess vital signs (especially O2 saturation and BP), inform the nephrologist immediately, and be prepared to administer oxygen. This could signal a dialyzer reaction or cardiac event.

How to Approach the Question

First, identify the negative framing of the question by spotting the keyword 'except'. This means you are looking for the option that is NOT a possible symptom or outcome.
Analyze each option based on the fundamental principles of hemodialysis.
Step 1: Consider the primary function of dialysis - fluid and waste removal. This makes 'Weight Loss' an expected outcome, so it's likely an incorrect answer to an 'except' question.
Step 2: Think about the underlying disease (end-stage renal disease). 'Anaemia' is a classic feature due to lack of erythropoietin, so it's an associated condition.
Step 3: Evaluate common complications. Fluid shifts can cause blood pressure changes. While hypotension is most common, hypertension is also possible. This makes it a 'possible symptom'.
Step 4: Evaluate the effect on oxygenation. The procedure involves an extracorporeal circuit and a foreign membrane (the dialyzer), which can trigger an inflammatory response affecting the lungs. This makes a decrease in oxygen (hypoxemia) a known risk. An increase in oxygen is therefore highly unlikely and the correct answer.

Concept Tested & Keywords

Concept Tested: Complications and expected outcomes of hemodialysis
Stem keywords: Haemodialysis, after the procedure, possible symptoms
Lead-in keywords: except
Negative lead-in flag: This is a negative-lead-in question asking for the finding that is NOT expected.

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E6 Medicine Harrison 22e Part 2 p. 304-306

E6 Medicine Davidson Principles Practice 24e p. 444-446