Page 1840 - Saunders Comprehensive Review For NCLEX-RN

the blood tubing.
7. Monitor for hypovolemia during dialysis, which can
occur from blood loss or excess fluid and electrolyte
removal.
8. Provide adequate nutrition; the client may eat before
or during dialysis.
9. Identify the client’s reactions to the treatment and
support coping mechanisms; encourage
independence and involvement in care.

Withhold antihypertensives and other medications that can

affect the BP or result in hypotension until after hemodialysis treatment.
Also withhold medications that could be removed by dialysis, such as
water-soluble vitamins, certain antibiotics, and digoxin.
VII. Access for Hemodialysis
A. Subclavian and femoral catheters
1. Description
a. A subclavian (subclavian vein) or
femoral (femoral vein) catheter may be
inserted for short-term or temporary
use in AKI.
b. The catheter is used until a fistula or
graft matures or develops, which is
typically 6 weeks, or may be required
when the client’s fistula or graft access
has failed because of infection or
clotting.
2. Interventions
a. Assess insertion site for hematoma,
bleeding, catheter dislodgement, and
infection.

b. These catheters should only be

used for dialysis treatments and
accessed by dialysis personnel.
c. Maintain an occlusive dressing over the
catheter insertion site.
3. Subclavian vein catheter
a. The catheter is usually filled with
heparin and capped to maintain
patency between dialysis treatments.
Heparin is aspirated from the line
before dialysis.
b. The catheter should not be uncapped
except for dialysis treatments.
c. The catheter may be left in place for up
to 6 weeks if no complications occur.

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