What special care is needed to transport a patient who receives kidney dialysis every three days?

• A. Keep the patient in a lateral recumbent position during transport.
• B. Keep the arm with the fistula elevated above the level of the kidneys.
• C. Dialysis patients require careful titration of IV fluids.
• D. Dialysis patients generally require large amounts of IV fluids.

Answer: (C)

Dialysis patients have a fragile fluid balance because their kidneys can’t regulate fluid and salt levels, and the dialysis process itself shifts fluids. During transport, giving IV fluids without caution can quickly cause fluid overload or destabilize blood pressure. The safest approach is to titrate IV fluids carefully—use the smallest amount needed and adjust slowly based on how the patient responds, monitoring blood pressure, pulse, and signs of edema or fluid overload. This careful management helps avoid both hypotension from overcorrection and fluid overload after dialysis. It’s also good practice to protect the fistula arm and avoid using that limb for IV access or blood pressure unless no alternative exists.