Dialysis Technician Practice Exam

What could lead to hypotension during and after dialysis?

1. Excessive fluid removal

2. Insufficient anticoagulation

3. Low dialysate temperature

4. Increased blood flow rates

The correct answer is: Excessive fluid removal

Hypotension during and after dialysis is often associated with the process of fluid removal. Excessive fluid removal occurs when a significant amount of fluid is taken out of the patient's body during treatment, which can lead to lower blood volume. As blood volume decreases, the heart has less fluid to pump, resulting in a drop in blood pressure — hence, hypotension. When dialysis is performed, it is essential to balance the fluid removal according to the patient's needs. Patients with a high ultrafiltration rate may experience a sudden shift in their blood pressure, particularly if they are already at risk due to factors such as medications, existing cardiovascular issues, or dehydration. Monitoring and adjusting the fluid removal rate is critical in preventing these hypotensive episodes during and after dialysis. Other factors like anticoagulation, dialysate temperature, and blood flow rates can have important effects on the dialysis process but are less directly tied to the occurrence of hypotension. Anticoagulation is primarily concerned with preventing clotting within the dialysis circuit, while dialysate temperature relates to the comfort and efficiency of the dialysis treatment but does not directly affect blood pressure to the same extent as fluid removal. Increased blood flow rates can sometimes improve treatment efficiency, but they, too, are not considered