Which symptoms indicate the need to increase the target weight?

Which symptoms indicate the need to increase the target weight?

• A. Nausea
• B. Hypertension
• C. Hypotension and cramping
• D. Headache

Answer: (C)

When evaluating how to adjust the target weight, you’re looking for signs that too much fluid was removed during dialysis. If ultrafiltration is too aggressive, the patient’s circulating volume drops quickly and the refill from the interstitial space can’t keep up. This leads to hypotension (low blood pressure) and muscle cramping—classic indicators that you’ve pulled out more fluid than the body can safely replace. Because of this, increasing the target weight (leaving more fluid in the patient) helps prevent these symptoms by reducing the amount of fluid removed. Nausea or headache can occur for various reasons and aren’t as specific to excessive fluid removal. Hypertension suggests fluid excess rather than too little removal, so it doesn’t point toward raising the target weight.

When evaluating how to adjust the target weight, you’re looking for signs that too much fluid was removed during dialysis. If ultrafiltration is too aggressive, the patient’s circulating volume drops quickly and the refill from the interstitial space can’t keep up. This leads to hypotension (low blood pressure) and muscle cramping—classic indicators that you’ve pulled out more fluid than the body can safely replace. Because of this, increasing the target weight (leaving more fluid in the patient) helps prevent these symptoms by reducing the amount of fluid removed.

Nausea or headache can occur for various reasons and aren’t as specific to excessive fluid removal. Hypertension suggests fluid excess rather than too little removal, so it doesn’t point toward raising the target weight.