How do you handle patients who require modifications to their dialysis treatment plan due to liver disease or failure?

Sample interview questions: How do you handle patients who require modifications to their dialysis treatment plan due to liver disease or failure?

Sample answer:

1. Assess the Patient’s Condition:
2. Evaluate the stage of liver disease or failure.
3. Assess liver function tests, including bilirubin, albumin, and coagulation studies.

4. Consider the underlying cause of liver disease, such as hepatitis, cirrhosis, or autoimmune disorders.

5. Monitor Fluid and Electrolyte Balance:

6. Liver disease can lead to fluid retention and electrolyte imbalances.
7. Adjust dialysis prescription to prevent fluid overload or dehydration.

8. Monitor serum sodium, potassium, calcium, and magnesium levels.

9. Manage Proteinuria:

10. Liver disease can cause proteinuria, leading to hypoalbuminemia and increased risk of edema.
11. Use hemofiltration or hemodiafiltration to remove protein-bound toxins and reduce proteinuria.

12. Consider albumin infusions to maintain oncotic pressure.

13. Adjust Dialysis Frequency and Duration:

14. Short, frequent dialysis sessions may be more appropriate to avoid hemodynamic instability and fluid overload.

15. Consider overnight dialysis or extended-hour dialysis to improve patient tolerance and achieve adequate dialysis.

16. Monitor Coagulation Parameters:

17. Liver disease can affect coagulation, increasing the risk of bleeding or thrombosis.
18. Monitor coagulation studies, including prothrombin time (PT) and partial thromboplastin time (PTT).

19. Adjust heparin dosing as needed to maintain adequate anticoagulation during dialysis.

20. Manage Hepatic Encephalopathy:

21. Liver failure can lead to hepatic encephalopathy, characterized by altered mental status and neuropsychiatric s… Read full answer

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