During hemodialysis for kidney failure, a client suddenly reports nausea, headache, and restlessness. What is the nurse's priority action?
Encourage oral fluids and reassess vital signs.
Provide comfort measures such as a cool compress.
Decrease the dialysis flow rate immediately.
Continue observation and inform the healthcare provider.
These early neurological symptoms suggest dialysis disequilibrium syndrome, caused by rapid shifts in solute concentration that can lead to cerebral edema. The most effective immediate intervention is to reduce or pause the dialysis flow rate, which slows solute removal and lowers the osmotic gradient between blood and brain. Comfort measures or extra fluids do not correct the underlying problem, and delaying intervention while only observing could allow symptoms to worsen. Notifying the provider is important but should occur after the dialysis rate is decreased to stabilize the client.
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