Pharmacology Urinary & Renal Meds #3

Question

The nurse is caring for a patient with chronic renal failure who receives dialysis every third day. The nurse notices that atenolol is ordered daily in the morning. The nurse places an alert on the patient’s medication record to reflect which important intervention regarding administration of the atenolol?

Answers

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

      This answer is not correct because medications taken prior to dialysis will be removed from the body’s system as a result of dialysis. The medication would be useless and the patient would either need to receive the medication again or would have to go without (if taking home meds). This could become very serious for the patient. The patient should be educated regarding this and nurses should be sure to make a note to not give medications prior to dialysis.

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

      This answer is not correct because prescribed medications are essential treatment for the patient and should not be discontinued on dialysis days but just administered following dialysis.

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

      This answer is correct because medications taken prior to dialysis will be removed from the body’s system as a result of dialysis. If a nurse administered the medication prior to dialysis, the medication would be useless and the patient would either need to receive the medication again or would have to go without (if taking home meds). This could become very serious for the patient. The patient should be educated regarding this and nurses should be sure to make a note to not give medications prior to dialysis.

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

      This answer is not correct because the dialysis nurse would not be responsible for administering regular medications to the patient following dialysis. The unit nurse would administer upon return to the unit from dialysis.

Overview

Patient medications should be administered on return from dialysis. Otherwise, the medications will be removed from the body and not effective.

Explanation

Administer the medication on return from dialysis. Medications taken prior to dialysis will be removed from the body’s system as a result of dialysis. Skipping days for a daily medication of atenolol (Tenormin) may cause hypertensive rebound. The dialysis nurse would not administer the drug during dialysis and would not be responsible after dialysis.

Learning Outcomes

Medications taken prior to dialysis will be removed from the body’s system as a result of dialysis. If a nurse administered the medication prior to dialysis, the medication would be useless and the patient would either need to receive the medication again or would have to go without (if taking home meds). This could become very serious for the patient. The patient should be educated regarding this and nurses should be sure to make a note to not give medications prior to dialysis.

Test Taking Tip

Remember that dialysis fistula shunts should be highly protected and no sticks or blood pressures performed on the side of the fistula shunts.

Video Rationale