Which action is typically taken to prevent intradialytic hypotension when adjusting medications?

• A. Double the dose of antihypertensives.
• B. Increase ultrafiltration rate.
• C. Administer diuretics.
• D. Hold or adjust antihypertensives per physician orders.

Answer: (D)

The key idea is that lowering a patient’s blood pressure medications during dialysis can help prevent dropping blood pressure inside the machine. Intradialytic hypotension happens when the blood pressure falls during treatment due to fluid removal and shifts in blood volume. If a patient is taking antihypertensives, those medications can contribute to a larger BP drop during dialysis. So, the best approach is to hold or adjust antihypertensive drugs according to physician orders, balancing the need to control blood pressure with the patient’s current fluid status and treatment plan.

Doubling antihypertensives would push BP down more, which increases the risk of hypotension. Increasing the ultrafiltration rate is not about medications and typically worsens hypotension by removing fluid faster. Diuretics during dialysis aren’t used to prevent IDH and don’t address the volume shifts that cause the problem. Adjusting antihypertensives per physician orders directly targets the medication-related risk of intradialytic hypotension.