Which actions by dialysis staff can help prevent disequilibrium?

To understand why the choice of decreasing the dialysate flow rate and utilizing a small dialyzer is correct for preventing disequilibrium, it’s important to consider the underlying mechanisms of dialysis and the potential risk factors associated with dialysis sessions.

Disequilibrium syndrome is a condition that can occur during or shortly after dialysis, primarily due to a rapid change in blood composition that leads to cerebral edema. This is often a consequence of the swift removal of solutes and fluid during dialysis, which creates a gradient that can cause fluid to shift into the brain.

By decreasing the dialysate flow rate, the rate at which solutes are removed from the blood is moderated. A slower flow allows for more gradual equalization between the concentrations in the blood and dialysate, reducing the risk of rapid changes that contribute to disequilibrium. Additionally, using a small dialyzer reduces the overall surface area available for ultrafiltration. This further keeps solute concentration changes at a more manageable level since smaller dialyzers allow for a gentler removal of toxins and excess fluid, promoting a more stable internal environment.

Other options listed may not effectively address the mechanisms that lead to disequilibrium. For instance, isolated ultrafiltration, when performed without proper dial