Nausea and vomiting during dialysis can occur for a number of reason:
- Motion sickness from the journey to dialysis
- Food consumed just before or during dialysis. Dialysis may divert blood flow away from the gut
- Rapid fluid removal
- Hypotension
- Non-dialysis related reasons e.g. intercurrent illness
Prevention and management:
- Address any intercurrent illness, seeking medical advice if required
- Advice patient not to eat prior to and during dialysis
- If nausea is related to travel, consider prescribing anti-emetics for the patient to take prior to commencing their journey
- Commence dialysis slowly, increasing blood flow during first 30 minutes of treatment
- If related to hypotension or excessive fluid removal refer to guidelines for weight and blood pressure management on haemodialysis
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