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

Hard

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

Explanation

the one symptom not typically associated with hemodialysis.
Increased arterial oxygen is not an expected outcome. In contrast, a decrease in arterial oxygen (intradialytic hypoxemia) is a recognized complication.
This hypoxemia can result from mechanisms like complement activation from the dialyzer membrane, leading to temporary sequestration of leukocytes in the pulmonary capillaries, and loss of carbon dioxide across the dialyzer.
Therefore, an increase in arterial oxygen is the physiological opposite of a known potential complication, making it the correct answer in an 'except' question.

Option A: Weight loss is an expected and primary goal of hemodialysis, achieved through the process of ultrafiltration to remove excess fluid accumulated between sessions.
Option B: Anaemia is a hallmark chronic condition in patients with end-stage renal disease (ESRD) due to deficient erythropoietin production. While not an acute symptom caused by a single session, it is an ever-present comorbidity in this patient population.
Option C: While hypotension is the most common hemodynamic complication during dialysis, a significant minority of patients experience intradialytic hypertension (a rise in blood pressure). Therefore, it is a possible, though less common, symptom.

Visual 1: Diagram - A schematic of the hemodialysis circuit, showing blood leaving the patient, passing through the dialyzer (with dialysate), and returning to the patient. This helps visualize the mechanism of fluid and solute removal.
Visual 2: Infographic - A chart listing common acute complications of hemodialysis, such as hypotension, muscle cramps, and dialyzer reactions, and chronic issues like anemia and bone disease.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Physiological effects and complications of hemodialysis in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Post-dialysis nursing assessment is critical. It includes monitoring for hypotension or hypertension, checking the patient's post-dialysis weight to confirm fluid removal, and assessing the access site for bleeding or clotting.
Nurses must be vigilant for signs of complications. Dizziness and cramping often signal hypotension, while shortness of breath could indicate fluid overload or, more rarely, a dialyzer reaction with hypoxemia.
What if? If a patient on dialysis suddenly develops chest pain and shortness of breath, the nurse should not assume it's fluid overload. It could be an acute cardiac event or a type A (anaphylactic) or type B (complement-mediated) dialyzer reaction, requiring immediate cessation of dialysis and emergency intervention.

How to Approach the Question

First, identify the keyword 'except'. This means you are looking for the option that is FALSE or not expected in the given context.
The question asks about possible symptoms after hemodialysis. Consider the main functions and common complications of this procedure.
Evaluate each option: 1. Does dialysis remove fluid? Yes, causing weight loss. 2. Are dialysis patients anemic? Yes, it's a chronic hallmark. 3. Can blood pressure rise? Yes, paradoxical hypertension can occur.
Finally, evaluate the last option: Does dialysis increase blood oxygen? The procedure is not designed for this and can sometimes cause a decrease. This contradicts the known physiology.
The option that is not a recognized outcome or complication is the correct answer to the 'except' question.

Concept Tested & Keywords

Concept Tested: Physiological effects and complications of hemodialysis.
Stem keywords: Haemodialysis, after procedure, symptoms
Lead-in keywords: except
Negative lead-in flag: The question uses the word 'except', asking for the finding that is NOT expected.

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