Medical Surgical Dialysis #3

Question

The nurse provides care for a client with chronic kidney disease (CKD) who receives dialysis every third day. The nurse notices that atenolol (Tenormin) is ordered daily in the morning. The nurse places an alert on the client’s medication record to reflect which important intervention regarding administration of the prescribed medication?

Answers

  1. Do not administer on dialysis days.
    • Rationale:

      This answer is not correct because skipping days for a daily medication of atenolol (Tenormin) may cause hypertensive rebound. Any medications scheduled to be given at a time the client is on hemodialysis will be given post hemodialysis unless specifically ordered.

  2. Give the medication just prior to leaving for dialysis.
    • Rationale:

      This answer is not correct because any medication that is administered prior to dialysis will be removed during the hemodialysis process; therefore, this is not an appropriate action by the nurse. Any medications scheduled to be given at a time the client is on hemodialysis will be given post hemodialysis unless specifically ordered.

  3. Administer the medication on return from dialysis.
    • Rationale:

      This answer is correct because most medications, but especially medications that are administered for hypertension, should not be administered prior to dialysis as they would be removed from the client’s system during the procedure. Therefore, the medication is held until the client returns post dialysis.

  4. Send the medication with the client for the dialysis nurse to administer.
    • Rationale:

      This answer is not correct because the dialysis nurse would not administer the drug during dialysis and would not be responsible after dialysis. Any medications scheduled to be given at a time the client is on hemodialysis will be given post hemodialysis unless specifically ordered.

Overview

Hemodialysis is a medical procedure to remove fluid and waste products from the blood and to correct electrolyte imbalances. Any medications scheduled to be given at a time the client is on hemodialysis will be given post hemodialysis unless specifically ordered.

Explanation

Learning Outcomes

Any medications scheduled to be given at a time the client is on hemodialysis will be given post hemodialysis unless specifically ordered. Medications taken prior to dialysis will be removed from the body’s system as a result of dialysis. Therefore, the nurse places a note in the medical record to administer the medication on return from dialysis.

Test Taking Tip

Consider the impact that dialysis has on medications within the body to answer this question correctly.

Video Rationale