Pre-dialysis assessment part 4

Haemodialysis 5

 

Review baseline information:

1. Weigh gain – ideally <5% of prescribed dry weight

2. If weigh gains are higher than this:

  • Educate patients in safe fluid intake, diet and how to reduce high salt intake        foods
  • Review whether there has been a reduction in native urine output;                        perform 24 hour collection (collected on days in between dialysis).                        Consider furosemide prescription in those with native urine output
  • If diabetic, review blood glucose levels, as if high this may increase thirst            and the need for fluids
  • If diabetic, review blood glucose levels, as if high this may increase thirst            and the need for fluids
  • If persistently finishing dialysis above dry weight consider if needs                       reassessment
  •  Consider use of blood volume monitoring if available, to help assess fluid              status

3. If weigh gains become  less than previously, consider need to reduce dry weight

4. If patient reports shortness of breath in period before dialysis session consider dry weight reduction

5. If patient reports increasing sub cutaneous oedema consider dry weight reduction

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