How do you handle patients who require modifications to their dialysis treatment plan due to pregnancy or lactation?

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

Sample answer:

Handling Dialysis Modifications During Pregnancy and Lactation

1. Patient Assessment and Education:

• Thoroughly assess the patient’s overall health, including pre-pregnancy comorbidities, gestational age, and expected delivery date.
• Educate the patient about the physiological changes during pregnancy and lactation and their potential impact on dialysis therapy.
• Provide anticipatory guidance on monitoring parameters, potential complications, and lifestyle modifications.

2. Dialysis Prescription Adjustment:

• Increase dialysis frequency and duration to account for increased blood volume and fluid retention.
• Adjust dialysis intensity based on serial bloodwork monitoring (BUN, creatinine), fluid balance, and symptomology.
• Consider implementing nocturnal dialysis to accommodate pregnancy-related fatigue and reduce fluid overload.

3. Medication Management:

• Monitor and adjust dialysis medications, such as erythropoietin and phosphate binders, to maintain therapeutic levels while minimizing potential teratogenicity.
• Discuss the use of lactational suppressants with the patient to avoid medication exposure to the infant through breast milk.

4. Nutritional Management:

• Ensure adequate protein intake to support fetal growth and tissue repair.
• Monitor serum electrolytes (sodium, potassium, calcium) and adjust dialysis parameters accordingly.
• Provide dietary counseling and recommend nutrient-rich foods to support mother and fetus.

5. Monitoring and… Read full answer