Pre-treatment assessment provides a foundation for successful treatment. Before the dialysis begins your nephrologists / medical director/dialysis clinical manager will assess your overall health. The assessment includes questions about your medical, personal history and as well as your access examination. The information gathered will helps your nephrologists to form and recommend a treatment plan specific to your needs.
Pre treatment assessment for new dialysis patients should include:
- Fluid status
- Respiratory assessment
- Neurologic assessment
- Cardiovascular assessment
- Gastrointestinal assessment
- General assessment
- Personal
- Access examination
Detailed pretreatment assessment for new patients:
General information
- Patient name
- Hospital no. / Medical record no.
- Treatment schedule:
2 times weekly / 3 times weekly (no. of dialysis treatment per week)
- First dialysis Treatment:
Date & Location
- Allergies: if any specify
- Vaccination: Vaccination status
Treatment Orders
- Dialyzer:
Type of dialyzer to be used
High/Middle/low flux dialyzer
Bio-compatible membrane
- Dialysate Bath:
Bicarbonate or acetate bath
- Treatment Time:
Depends on patient needs
- Blood Flow Rate (BFR):
Depends on the patient’s clearance needs
- Dialysate Flow Rate (DFR):
Depends on the patient’s clearance needs
- Heparin:
Depends on patients needs
- Medications during dialysis:
If any
Vascular access
- Access location:
- Date of access placed:
- Access type:
AVG/ AVF
CVC: Permanent/ Temporary
- Access Infection:
Physical Assessment
- Fluid Status:
- Edema: Yes/No. If Yes: Location of edema
- Fluid gains: If any
- Neurological:
- Patient is alert/responsive/slow response /appropriate/oriented calm/anxious/cooperative.
- Respiratory:
- Respirations: labored/unlabored/regular/irregular
- Respiratory rate: ____ breaths/min.
- Sounds: Clear/Crackles/Wheezes
- Fever:
- Productive/non-productive
- Duration:
- Exposure to TB: Yes/ no.
- Cardiovascular:
- Pulse rate:
- Chest pain:
- Peripheral pulses:
- Skin condition:
- Blood pressure: Sitting & Standing.
- Treatment for hypertension: Yes/no,
- Temperature:
- Gastrointestinal:
- Appetite: Good/Fair/Poor.
- Constipation: Yes/no
- Diarrhea: Yes/no
- Diabetic: Yes/no
- Medications: If any
General assessment:
- Mobility: Walk able/Wheel chair/ Stretcher
- Pain status:
Pain measurement by pain assessment tool
Location of pain:
- Skin color:
- Skin temperature:
- Wounds:
- Type of wound:
- Size and location:
- Prosthetic devices:
- Limb:
- Dentures:
- Spectacles:
- Hearing aids:
- Other:
- Personal:
- Hygiene: Good/Fair/Poor
- Tobacco: Yes/no
- Alcohol: yes/no,
- Social drugs: yes/no.
- Amount/type:
- Marital status: Single/Married/Divorced/Widow/widower
- Language:
- Primary language:
- Language barrier: Yes/ no
- Education:
- Surgical procedures:
- Surgery type:
- Date of previous surgeries:
- Complaints:
- Problems Identified:
- Action needed:
Good luck with your next new patient pre-treatment evaluation!!
LazyKidney 