What is the #1 Question to Ask Your Dialysis Patient?
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The questions that I ask all my dialysis patients is:
How has dialysis been going, any problems with dialysis?
I need to ask these questions to help make sure your next dialysis treatment is safe and your prescription is appropriate.
Most of the time I will get, “Fine, I think; I can’t remember, it’s all a blur”
And that’s great, nothing of note to remember.
Here are the top 5 things I assess as a dialysis nurse:
Trust me!
I’ll dig a little deeper, any problems?
And if you are new to dialysis, the next question is; what are problems?
1. If you cramped last treatment
2. Any Nausea, Vomiting, low blood pressures, or passing out last treatment
3. How you felt when you left dialysis
1. Did you feel great?
2. Or did you go home with a headache?
3. or go home and slept the rest of the day?
1. If I get a yes to any of these questions, I know I need to be careful with your fluid removal. I’ll use a crit line to help monitor your treatment, I might check your blood pressures a little more often, and I probably won’t be very “aggressive” with your fluid removal goal
4. Any problems with your Fistula or Catheter
1. Again, this opens the door to many more questions if this is a yes.
1. What happened with your fistula, has this been happening often or an outlier?
2. I’ll probably use an ultrasound to put the needles in, and it might not be appropriate for new dialysis staff to cannulate you.
3. When is the last time you had an surgical intervention on your fistula?
4. If it’s a new fistula, I might use smaller needles, or we will rest your fistula and use your catheter if you have one
2. Catheter problems -
1. this includes skin problems like itching or skin irritation is a common one. Because we have a solution for this.
2. Your catheter didn't’ work last treatment, did they use anything to declot the line? How did they resolve the issue, did you get your full treatment? How long have you had this catheter?
5. And if I had to choose the 5th most important thing is if you had any Dr. Appointments.
1. This questions opens the door to more questions like:
1. Medication changes
2. scheduled procedures
3. transplant workup
6. BONUS: always always tell me if you have any s/s of infection. Fevers, Chills, nausea, vomiting, draining wound, new wound, old wound with increase pain.
This is not a comprehensive list. But it is my TOP 5 favorite things to ask the dialysis patients. It gives me so much information.
I want you to know, by telling me these things that have happened to you, you are helping me critically thing to plan your dialysis treatment.
You are helping me choose your fluid goal, if your dry or “ideal” weight is accurate, how you are tolerating fluid removal.
At your dialysis appointment I am looking at a lot of things. What your dry weight it, how much weight you gained between treatment.
00:00 The Question!
01:15 Fatigue, Headaches
01:48 Nausea/Vomiting
02:05 Critical Thinking
03:00 Catheter/Needle Problems
06:21 Other Question
08:40 Out-Take
DISCLAIMER: This video is intended for education purposes only and is not intended as medical advice
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2 авг 2024
