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학습 자료 둘러보기 →The highest priority nursing intervention during hemodialysis is to continuously assess for signs of disequilibrium syndrome. This rare but serious complication arises from rapid osmotic shifts that can cause cerebral edema.
Patients at highest risk are those undergoing their first hemodialysis treatment with severe azotemia, marked by extremely elevated BUN and creatinine levels. Symptoms can manifest within 15-30 minutes of initiation.
Monitor for early neurological signs such as nausea, vomiting, headache, confusion, restlessness, or decreased responsiveness. Progression can lead to seizures or coma, requiring immediate intervention.
Do not confuse restlessness or headache with simple discomfort. Prioritize neurological assessment over comfort measures like pain medication. Slowing the blood flow rate or administering mannitol may be required per protocol.
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