One of the major complications that occur during hemodialysis is?

Appeared in: ISRO- 2016

Explanation

Hypotension is the most frequent acute complication during hemodialysis, primarily caused by the rapid removal of fluid (ultrafiltration) from the vascular space.
The rate of fluid removal can outpace the body's ability to shift fluid from the interstitial and intracellular spaces back into the blood vessels, leading to a drop in blood pressure.
This complication is significant because it can cause symptoms like nausea, vomiting, dizziness, and lightheadedness, and if severe, can lead to reduced perfusion of vital organs.

Option A: While muscle cramps are a common and uncomfortable side effect of hemodialysis, they are generally considered less clinically significant and less of a 'major' complication than a sudden, symptomatic drop in blood pressure.
Option C: Air embolism is a life-threatening medical emergency, but it is an extremely rare event with modern hemodialysis machines that have sophisticated air detection alarms.
Option D: Pulmonary edema is a primary reason for initiating hemodialysis, as it is a sign of severe fluid overload. Dialysis is the treatment for pulmonary edema in this context, not the cause of it.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of Hemodialysis as background academic context rather than a clinical decision trigger.
Nurses play a critical role in preventing and managing intradialytic hypotension by closely monitoring the patient's vital signs, especially blood pressure, throughout the treatment.
Prompt nursing interventions, such as reducing the ultrafiltration rate, administering a saline bolus, and adjusting the patient's position, are essential for patient safety and comfort.
Patient education is key. Nurses should advise patients to report symptoms like dizziness, nausea, or cramping immediately.

How to Approach the Question

First, identify the keywords in the question: 'major complication' and 'hemodialysis'.
Interpret 'major' in a clinical context to mean something that is both common and has significant potential for harm or requires intervention.
Systematically review the options:
Muscle cramps: Common, but usually not life-threatening.
Hypotension: Very common and can lead to serious issues like falls or organ hypoperfusion.
Air embolism: Very rare, though severe.

Concept Tested & Keywords

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

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

Practise the full ISRO- 2016

Attempt every question from this paper in a timed mock, then review the full solution for each one.