Page 1845 - Saunders Comprehensive Review For NCLEX-RN

failure.
9. Notify the PHCP immediately if signs of clotting,
infection, or arterial steal syndrome occur.

To ensure patency, palpate for a thrill or auscultate for a bruit

over the fistula or graft. Notify the PHCP if a thrill or bruit is absent.
VIII. Complications of Hemodialysis (Box 54-7)
A. If signs of complications occur, the dialysis is slowed or stopped,
depending on the complication, and the PHCP is notified
immediately.
B. The nurse stays with the client and monitors the client, including
vital signs, while another nurse obtains initial prescriptions from
the PHCP.
C. See Priority Nursing Actions for air embolism.

Priority Nursing Actions

Air Embolism in a Client Receiving Hemodialysis

1. Stop the hemodialysis.
2. Turn the client on the left side, with the head down (Trendelenburg’s position).
3. Notify the primary health care provider (PHCP) and Rapid Response Team for
the hospitalized client.
4. Administer oxygen.
5. Assess vital signs and pulse oximetry.
6. Document the event, actions taken, and the client’s response.

Reference
Ignatavicius, Workman, Rebar (2018), p. 214.

IX. Peritoneal Dialysis
A. Description
1. The peritoneum acts as the dialyzing membrane
(semipermeable membrane) to achieve dialysis, and
the membrane is accessed by insertion of a PD
catheter through the abdomen.
2. PD works on the principles of osmosis, diffusion, and
ultrafiltration; PD occurs via the transfer of fluid and
solute from the bloodstream through the peritoneum
into the dialysate solution.
3. The peritoneal membrane is large and porous,
allowing solutes and fluid to move via osmosis from
an area of higher concentration in the body to an area

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