Page 1838 - Saunders Comprehensive Review For NCLEX-RN

inability to filter out these waste products.
B. Assessment
1. Oliguria
2. Presence of protein, red blood cells, and casts in the
urine
3. Elevated levels of urea, uric acid, potassium, and
magnesium in the urine
4. Hypotension or hypertension
5. Alterations in the level of consciousness
6. Electrolyte imbalances
7. Stomatitis
8. Nausea or vomiting
9. Diarrhea or constipation
C. Interventions
1. Monitor vital signs for hypertension, tachycardia, and
an irregular heart rate.
2. Monitor serum electrolyte levels.
3. Monitor intake and output and for oliguria.
4. Provide a limited but high-quality protein diet as
prescribed.
5. Provide a limited sodium, nitrogen, potassium, and
phosphate diet as prescribed.

6. Assist the client to cope with body image

disturbances caused by uremic syndrome.
VI. Hemodialysis

A. Description

1. Hemodialysis is an intermittent renal replacement
therapy involving the process of cleansing the client’s
blood.
2. It involves the diffusion of dissolved particles from 1
fluid compartment into another across a
semipermeable membrane; the client’s blood flows
through 1 fluid compartment of a dialysis filter, and
the dialysate is in another fluid compartment.
B. Functions of hemodialysis
1. Cleanses the blood of accumulated waste products
2. Removes the byproducts of protein metabolism such
as urea, creatinine, and uric acid from the blood
3. Removes excess body fluids
4. Maintains or restores the buffer system of the body
5. Corrects electrolyte levels in the body
C. Principles of hemodialysis
1. The semipermeable membrane is made of a thin,
porous cellophane.
2. The pore size of the membrane allows small particles

1838