If a patient presents with shortness of breath and edema during dialysis, what is the likely plan regarding treatment parameters?

If a patient presents with shortness of breath and edema during dialysis, what is the likely plan regarding treatment parameters?

• A. The nurse will reduce the blood flow rate
• B. The nurse will get an order to increase the TW
• C. The nurse will decrease dialysate temperature
• D. The nurse will order more diuretics

Answer: (B)

During dialysis, these symptoms point to fluid status being a major factor. The setting that determines how much fluid the machine removes is the target weight. Increasing the target weight means the machine will remove less fluid this session, reducing the ultrafiltration rate. This helps ease pulmonary congestion and edema and can prevent intradialytic hypotension or intolerance when a patient is already showing shortness of breath and edema. Other options don’t address the situation as directly: lowering the blood flow rate slows overall clearance but won’t specifically limit fluid removal this session; lowering dialysate temperature can affect hemodynamics but isn’t the targeted fix for edema during treatment; using diuretics during dialysis isn’t typically appropriate in patients already on dialysis, since many are anuric and this wouldn’t resolve the immediate intradialytic fluid overload.

During dialysis, these symptoms point to fluid status being a major factor. The setting that determines how much fluid the machine removes is the target weight. Increasing the target weight means the machine will remove less fluid this session, reducing the ultrafiltration rate. This helps ease pulmonary congestion and edema and can prevent intradialytic hypotension or intolerance when a patient is already showing shortness of breath and edema.

Other options don’t address the situation as directly: lowering the blood flow rate slows overall clearance but won’t specifically limit fluid removal this session; lowering dialysate temperature can affect hemodynamics but isn’t the targeted fix for edema during treatment; using diuretics during dialysis isn’t typically appropriate in patients already on dialysis, since many are anuric and this wouldn’t resolve the immediate intradialytic fluid overload.