Dialysis management in severe cramps:
Immediate:
- Reduce ultrafiltration rate
- Reduce blood flow rate
- Massage limb if possible
- Administer oxygen
- Administer 0.9% sodium chloride (or machine prepared solution) in measured boluses
- Re-assess fluid removal and patient dry weight
Then:
- Re-educate patient re-fluid intake if weight gain is excessive
- Measured native urine output and maximise with diuretics
- Refer to dietitian to review sodium intake
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